Provider Demographics
NPI:1710261508
Name:MK DISTRIBUTORS
Entity Type:Organization
Organization Name:MK DISTRIBUTORS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KAY
Authorized Official - Middle Name:
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-719-8032
Mailing Address - Street 1:25010 OAKHURST DR
Mailing Address - Street 2:250
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77386-2719
Mailing Address - Country:US
Mailing Address - Phone:281-719-8032
Mailing Address - Fax:832-813-5713
Practice Address - Street 1:25010 OAKHURST DR
Practice Address - Street 2:250
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77386-2719
Practice Address - Country:US
Practice Address - Phone:281-719-8032
Practice Address - Fax:832-813-5713
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-28
Last Update Date:2011-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1000611333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy