Provider Demographics
NPI:1689744781
Name:MEDICAL DEVELOPMENTS INC
Entity Type:Organization
Organization Name:MEDICAL DEVELOPMENTS INC
Other - Org Name:COXHEALTH PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JEFF
Authorized Official - Middle Name:
Authorized Official - Last Name:HAWKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:417-269-6263
Mailing Address - Street 1:3800 S NATIONAL AVE
Mailing Address - Street 2:SUITE #110
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65807-5209
Mailing Address - Country:US
Mailing Address - Phone:417-269-5988
Mailing Address - Fax:417-269-5986
Practice Address - Street 1:3800 S NATIONAL AVE
Practice Address - Street 2:SUITE #110
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65807-5209
Practice Address - Country:US
Practice Address - Phone:417-269-5988
Practice Address - Fax:417-269-5986
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-08
Last Update Date:2019-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO005537333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO606772705Medicaid
MO606772705Medicaid