Provider Demographics
NPI:1346375268
Name:UNIVERSITY HEALTH CENTER TYLER-DME
Entity Type:Organization
Organization Name:UNIVERSITY HEALTH CENTER TYLER-DME
Other - Org Name:U.T. HOME CARE SOLUTION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF PHARMACY
Authorized Official - Prefix:MRS
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:MAEKER
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:903-877-7096
Mailing Address - Street 1:11937 US HIGHWAY 271
Mailing Address - Street 2:ATTN: OUTPATIENT PHARMACY
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75708-3154
Mailing Address - Country:US
Mailing Address - Phone:903-877-7904
Mailing Address - Fax:903-877-5039
Practice Address - Street 1:11937 US HIGHWAY 271
Practice Address - Street 2:ATTN: OUTPATIENT PHARMACY
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75708-3154
Practice Address - Country:US
Practice Address - Phone:903-877-7904
Practice Address - Fax:903-877-5039
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UNIVERSITY OF TEXAS HEALTH CENTER AT TYLER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-02-22
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX152846502Medicaid
TX152846501Medicaid
TX152846502Medicaid