Provider Demographics
NPI:1093366106
Name:MEDCENTRIX PHARMACY, LLC
Entity Type:Organization
Organization Name:MEDCENTRIX PHARMACY, LLC
Other - Org Name:MEDCENTRIX PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:APRIL
Authorized Official - Middle Name:
Authorized Official - Last Name:MEEKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-888-8284
Mailing Address - Street 1:5720 BANDERA RD STE 4B
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78238-1950
Mailing Address - Country:US
Mailing Address - Phone:210-888-8284
Mailing Address - Fax:281-888-8284
Practice Address - Street 1:5720 BANDERA RD STE 4B
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78238-1950
Practice Address - Country:US
Practice Address - Phone:210-888-8284
Practice Address - Fax:281-888-8284
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-20
Last Update Date:2020-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX32875OtherTEXAS STATE BOARD OF PHARMACY