Provider Demographics
NPI:1174631667
Name:TOMELDON CORPORATION
Entity Type:Organization
Organization Name:TOMELDON CORPORATION
Other - Org Name:THE MEDICINE SHOPPE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:TOM
Authorized Official - Middle Name:ELDON
Authorized Official - Last Name:SIEGENTHALER
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:817-274-0050
Mailing Address - Street 1:2220 W PARK ROW DR STE A
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76013
Mailing Address - Country:US
Mailing Address - Phone:817-274-0050
Mailing Address - Fax:817-860-6083
Practice Address - Street 1:2220 W PARK ROW DR STE A
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76013
Practice Address - Country:US
Practice Address - Phone:817-274-0050
Practice Address - Fax:817-860-6083
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-26
Last Update Date:2014-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX157373336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
4582397OtherNABP