Provider Demographics
NPI:1255471215
Name:AMEHRCO ENTERPRISES,INC
Entity Type:Organization
Organization Name:AMEHRCO ENTERPRISES,INC
Other - Org Name:MEDFIRST PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SIAMAK
Authorized Official - Middle Name:KIANI
Authorized Official - Last Name:KEIVAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:915-595-1300
Mailing Address - Street 1:PO BOX 27216
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79926-7216
Mailing Address - Country:US
Mailing Address - Phone:915-595-1300
Mailing Address - Fax:
Practice Address - Street 1:7878 GATEWAY BLVD E STE 102
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79915-1802
Practice Address - Country:US
Practice Address - Phone:915-595-1300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX18965333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX144748Medicaid
TX144748Medicaid
TX4588224Medicare ID - Type UnspecifiedNABP