Organization
HMT DERMATOLOGY ASSOCIATES, INC.
Active
Other names
Kwik-Fil Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
TAMMIE MISKIMINS (MANAGER, PHARMACY LICENSING/CONTRAC)
(817) 572-0009
Entity
Organization
Contact information
Practice address
5779 WOOSTER PIKE, SUITE A, MEDINA, OH 44256-8816
(888) 245-5590
(888) 245-5650
Mailing address
1620 W. NORTHWEST HWY, SUITE 100, GRAPEVINE, TX 76051
(817) 572-0009
(817) 720-1039
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PMY.02748400-03
OH
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2169958
PK
—
Enumeration date
06/21/2017
Last updated
06/21/2017
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