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Organization

MEDICINE PLACE INC 1008 LAMAR ST SWEETWATER TX

Active
Other names
The Medicine Place Pharmacy #2
Organization subpart
No

Provider details

NPI number
Authorized official
MR. PAUL GILBERT JOHNSON R.PH. (PHARMACIST IN CHARGE/V.P./OWNER)
(325) 728-3489
Entity
Organization

Contact information

Practice address
2250 CHESTNUT ST., COLORADO CITY, TX 79512-3485
(325) 728-3489
(325) 728-8683
Mailing address
2250 CHESTNUT ST., COLORADO CITY, TX 79512-3485
(325) 728-3489
(325) 728-8683

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
10882
TX
333600000X
Pharmacy
Primary
10882
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
10882
TX STATE BOARD LIC #
TX
05
142688
TX
01
4567814
NCPDP# (FORMERLY NABP#)
TX
Enumeration date
08/18/2005
Last updated
03/07/2023
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