Organization
PHARMACY AND SURGICAL SUPPLIES INC
Active
Other names
Pharmacy and Surgical Supplies Inc
Organization subpart
No
Provider details
NPI number
Authorized official
MITESH MARADIA (MEMBER)
(972) 693-8079
Entity
Organization
Contact information
Practice address
10300 SCYENE RD # 102, DALLAS, TX 75227-4932
(469) 283-8878
(469) 375-5385
Mailing address
10300 SCYENE RD # 102, DALLAS, TX 75227-4932
(469) 283-8878
(469) 375-5385
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
30350
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
14940501
—
TX
01
—
2155622
PK
—
Enumeration date
12/03/2015
Last updated
06/15/2021
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