Organization
MEDICINE MAN, L.P.
Active
Organization
MEDICINE MAN, L.P.
Active
Other names
Santa Fe Medicine Man, L.P.
Organization subpart
No
Provider details
NPI number
Authorized official
ERNEST H. ZOST RPH (PRESIDENT & CEO)
(972) 860-0202
Entity
Organization
Contact information
Practice address
13250 HIGHWAY 6, SANTA FE, TX 77510-7682
(409) 925-3522
(409) 925-9958
Mailing address
16250 DALLAS PKWY, SUITE 100, DALLAS, TX 75248-2626
(972) 860-0200
(972) 860-0298
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
20997
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
145138
—
TX
Enumeration date
04/24/2006
Last updated
08/22/2020
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