Provider Demographics
NPI:1841263951
Name:PRO MED PHARMACIES INC
Entity type:Organization
Organization Name:PRO MED PHARMACIES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:R
Authorized Official - Last Name:CHRYSLER
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:806-379-7126
Mailing Address - Street 1:3615 SW 45TH AVE
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79109-5662
Mailing Address - Country:US
Mailing Address - Phone:806-379-7126
Mailing Address - Fax:806-372-3984
Practice Address - Street 1:701 N TAYLOR
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79107-5279
Practice Address - Country:US
Practice Address - Phone:806-376-8245
Practice Address - Fax:806-379-7514
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-09
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0083114332B00000X
TX13048333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX13048OtherTEXAS PHARMACY LICENSE
KY5403049900Medicaid
TX83114OtherMEDICAL DEVICE DISTRIBUTI
CANRP57OtherNON RESIDENT
KY9000358300Medicaid
TX108484001Medicaid
TX4578235OtherNCPDP
TXW0070866OtherCONTROLLED SUBSTANCE
TXW0070866OtherCONTROLLED SUBSTANCE
BP1677078OtherDEA
TX4578235OtherNCPDP