Active NPI
The Med Shop
- Pharmacy
- Jefferson, TX
National Provider Identifier
1124116561
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy
- License
- 25114
- Legal business name
- THE MED SHOP
- Practice address
- 110 N . Walnut
Jefferson, TX 75657 - Phone
- (903) 665-2525
- Fax
- (903) 665-2526
- NPI assigned
- Oct 11, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. George E Teel
- Title
- Owner
- Phone
- (903) 639-3508
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Oxygen Equipment & Supplies (DME) | 332BX2000X | 25114 | TX | |
| Pharmacy | 333600000X | 25114 | TX | Primary |
Addresses
Primary practice location
110 N . Walnut
Jefferson, TX 75657
Mailing address
110 N Walnut
Jefferson, TX 75657
Phone (903) 665-2525
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 25114 | Other | TX | PHARMACY |
National Provider Directory
National Provider Directory- Tax ID family
- The Med Shop
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Community/Retail Pharmacy
- Hughes Springs, TX
- NPI 1144231630
Locations
110 N Walnut St
Jefferson, TX 75657
Phone (903) 665-2525
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160524800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1757548800000",
"number": "1124116561",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "110 N WALNUT",
"city": "JEFFERSON",
"state": "TX",
"postal_code": "75657",
"telephone_number": "903-665-2525",
"fax_number": "903-665-2526"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "110 N . WALNUT",
"city": "JEFFERSON",
"state": "TX",
"postal_code": "75657",
"telephone_number": "903-665-2525",
"fax_number": "903-665-2526"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "THE MED SHOP",
"organizational_subpart": "NO",
"enumeration_date": "2006-10-11",
"last_updated": "2025-09-11",
"status": "A",
"authorized_official_last_name": "TEEL",
"authorized_official_first_name": "GEORGE",
"authorized_official_middle_name": "E",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "903-639-3508",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "332BX2000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
"state": "TX",
"license": "25114",
"primary": false
},
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": "TX",
"license": "25114",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHARMACY",
"identifier": "25114",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Jefferson, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.