Organization
MEDICAL MART & DME
Active
Organization
MEDICAL MART & DME
Active
Other names
Health Plus Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM FATANTHONY (PIC)
(956) 424-3535
Entity
Organization
Contact information
Practice address
1315 W MAIN AVE STE 12, ALTON, TX 78573-1643
(956) 424-3535
(956) 424-3599
Mailing address
3401 W MILE 5 RD, SUITE 2, MISSION, TX 78574-5313
(956) 424-3535
(956) 424-3599
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
332BD1200X
Dialysis Equipment & Supplies (DME)
—
—
332BN1400X
Nursing Facility Supplies (DME)
—
—
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
30680
TX
3336C0004X
Compounding Pharmacy
—
—
3336H0001X
Home Infusion Therapy Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
146638
—
TX
01
—
2158331
PK
—
Enumeration date
02/26/2016
Last updated
04/15/2016
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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