Provider Demographics
NPI:1568503688
Name:MEDICINE SHOPPES, INC.
Entity Type:Organization
Organization Name:MEDICINE SHOPPES, INC.
Other - Org Name:BELLS FAMILY DRUG
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:
Authorized Official - Last Name:MCANALLY
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:214-734-8878
Mailing Address - Street 1:2535 ELDORADO PKWY
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070-4366
Mailing Address - Country:US
Mailing Address - Phone:903-965-7383
Mailing Address - Fax:903-965-9925
Practice Address - Street 1:103 W. BELLS BLVD
Practice Address - Street 2:
Practice Address - City:BELLS
Practice Address - State:TX
Practice Address - Zip Code:75414
Practice Address - Country:US
Practice Address - Phone:903-965-7383
Practice Address - Fax:903-965-9925
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14629333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX143722Medicaid
TX4572702OtherNCPDP NUMBER
TX14629OtherTEXAS PHARMACY LICENSE