Organization
THE MEDICINE PLACE INC 1008 LAMAR ST SWEETWATER TX
Active
Other names
THE MEDICINE PLACE
Organization subpart
No
Provider details
NPI number
Authorized official
TEDDY BASYE RPH (PRESIDENT)
(325) 236-6809
Entity
Organization
Contact information
Practice address
1410 LAMAR ST, SWEETWATER, TX 79556-7124
(325) 236-6809
(325) 236-6800
Mailing address
1410 LAMAR ST, SWEETWATER, TX 79556-7124
(325) 236-6809
(325) 236-6800
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
10620
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
142643
—
TX
01
—
4566886
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
08/18/2006
Last updated
08/08/2011
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