Organization
MEDI-HEALTH PHARMACY GROUP LLC
Active
Other names
Keller Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
NIRAV PATEL (PHARMACIST-IN-CHARGE)
(973) 698-0143
Entity
Organization
Contact information
Practice address
1200 KELLER PKWY STE 200, KELLER, TX 76248-3615
(682) 593-0461
(682) 593-0460
Mailing address
1200 KELLER PKWY, SUITE 200, KELLER, TX 76248-3615
(682) 593-0461
(682) 593-0460
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
27642
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5904049
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
09/14/2011
Last updated
11/15/2011
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