Organization
MEDICINE SHOPPE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN GUINN (MEDICAID MEDICARE BILLING SPEC)
(314) 993-6000
Entity
Organization
Contact information
Practice address
6500 NORTHWEST DR, SUITE 385, MESQUITE, TX 75150-6849
(972) 613-6768
(972) 613-7477
Mailing address
1100 N LINDBERGH BLVD, SAINT LOUIS, MO 63132-2914
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
19942
TX
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
144945
—
TX
01
—
4512643
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
08/20/2006
Last updated
09/11/2025
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