Organization
MED SHOP PHARMACY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICK WAYNE POWERS (PHARMACIST/OWNER)
(903) 680-2600
Entity
Organization
Contact information
Practice address
825 US HIGHWAY 271 N, GILMER, TX 75644-5580
(903) 680-2600
(903) 680-2605
Mailing address
825 US HIGHWAY 271 N, GILMER, TX 75644-5580
(903) 680-2600
(903) 680-2605
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
148119
—
TX
Enumeration date
12/12/2019
Last updated
09/04/2024
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