Organization
ACE MEDICAL PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL MAYHALL RPH (PHARMACIST)
(512) 444-2391
Entity
Organization
Contact information
Practice address
611 W BEN WHITE BLVD, AUSTIN, TX 78704-7187
(512) 444-2391
(512) 444-5560
Mailing address
611 W BEN WHITE BLVD, AUSTIN, TX 78704-7187
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
22286
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
145209
—
TX
01
—
4512960
OTHER ID NUMBER
—
Enumeration date
10/16/2007
Last updated
10/16/2007
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