Organization
MT. PLEASANT PHARMACY, INC.
Active
Other names
MCKELLER'S MEDICINE CHEST VITAL CARE
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES WILSON (PRESIDENT)
(903) 572-4397
Entity
Organization
Contact information
Practice address
609 N JEFFERSON AVE, MT PLEASANT, TX 75455-3646
(903) 572-4397
(903) 572-5912
Mailing address
PO BOX 5047, MERIDIAN, MS 39302-5047
(800) 447-4095
(601) 482-7490
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
18708
TX
332BC3200X
Customized Equipment (DME)
18708
TX
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
18708
TX
332BX2000X
Oxygen Equipment & Supplies (DME)
18708
TX
333600000X
Pharmacy
18708
TX
3336C0003X
Community/Retail Pharmacy
18708
TX
3336H0001X
Home Infusion Therapy Pharmacy
18708
TX
3336L0003X
Long Term Care Pharmacy
18708
TX
3336M0002X
Mail Order Pharmacy
18708
TX
3336S0011X
Specialty Pharmacy
Primary
18708
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
519758
BCBS
TX
01
—
750612
HIT
TX
Enumeration date
09/13/2006
Last updated
09/11/2025
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