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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
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