Provider Demographics
NPI:1225035892
Name:M & G MEDPHARM, INC.
Entity Type:Organization
Organization Name:M & G MEDPHARM, INC.
Other - Org Name:MEDICAP PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST, OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MANUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MORIN
Authorized Official - Suffix:
Authorized Official - Credentials:R PH
Authorized Official - Phone:956-631-7979
Mailing Address - Street 1:1623 PECAN BLVD
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78501-4214
Mailing Address - Country:US
Mailing Address - Phone:956-631-7979
Mailing Address - Fax:956-631-8113
Practice Address - Street 1:1623 PECAN BLVD
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78501-4214
Practice Address - Country:US
Practice Address - Phone:956-631-7979
Practice Address - Fax:956-631-8113
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-28
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX17273333600000X
TX3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX144491Medicaid
TX4598263OtherNABP
TXBM4981622OtherDEA NUMBER
TX4598263OtherNABP
TXBM4981622OtherDEA NUMBER