| NPI | 1598163149 |
|---|---|
| Doing Business As | MEDEASE RX PHARMACY |
| Entity Type | Organization |
| Authorized Contact | TAMMIE MISKIMINS Mgr. Licensing & Third Party 817-572-0009 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: TX 29636) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2014-12-15 |
| Last Update Date | 2016-06-28 |