Organization
MLB PHARMACY LLC
Active
Organization
MLB PHARMACY LLC
Active
Other names
Vital Care Infusion Services
Organization subpart
No
Provider details
NPI number
Authorized official
MICAH PRATT PHARMD (OWNER)
(325) 777-1423
Entity
Organization
Contact information
Practice address
11 W BEAUREGARD AVE, SAN ANGELO, TX 76903-5832
(325) 777-1423
(325) 777-1430
Mailing address
11 W BEAUREGARD AVE, SAN ANGELO, TX 76903-5832
(806) 548-0590
Taxonomy
Speciality
Code
Description
License number
State
251F00000X
Home Infusion Agency
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
—
—
3336H0001X
Home Infusion Therapy Pharmacy
—
—
Other
Enumeration date
09/20/2021
Last updated
11/17/2022
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