Provider Demographics
NPI:1952322513
Name:BELINDA KAYE MCGRAW
Entity Type:Organization
Organization Name:BELINDA KAYE MCGRAW
Other - Org Name:MEDICINE SHOPPE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BELINDA
Authorized Official - Middle Name:K
Authorized Official - Last Name:MCGRAW
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:409-384-3432
Mailing Address - Street 1:494 SPRINGHILL ST
Mailing Address - Street 2:
Mailing Address - City:JASPER
Mailing Address - State:TX
Mailing Address - Zip Code:75951-4922
Mailing Address - Country:US
Mailing Address - Phone:409-384-3432
Mailing Address - Fax:409-384-5843
Practice Address - Street 1:494 SPRINGHILL ST
Practice Address - Street 2:
Practice Address - City:JASPER
Practice Address - State:TX
Practice Address - Zip Code:75951-4922
Practice Address - Country:US
Practice Address - Phone:409-384-3432
Practice Address - Fax:409-384-5843
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-21
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX23025332B00000X, 3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX169709602Medicaid
TX4524333OtherNCPDP #
TX169709601Medicaid
TXBT8677405OtherDEA #
TX169709601Medicaid