Provider Demographics
NPI:1932728375
Name:SAMDUMU INTERNATIONAL LLC
Entity Type:Organization
Organization Name:SAMDUMU INTERNATIONAL LLC
Other - Org Name:TAYLOR AREA PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:DUPLI
Authorized Official - Middle Name:
Authorized Official - Last Name:SAMDUMU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-363-6642
Mailing Address - Street 1:1001 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:TAYLOR
Mailing Address - State:TX
Mailing Address - Zip Code:76574-3233
Mailing Address - Country:US
Mailing Address - Phone:512-309-4238
Mailing Address - Fax:
Practice Address - Street 1:1001 N MAIN ST
Practice Address - Street 2:
Practice Address - City:TAYLOR
Practice Address - State:TX
Practice Address - Zip Code:76574-3233
Practice Address - Country:US
Practice Address - Phone:512-309-4238
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-15
Last Update Date:2021-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy