Kindle Mayberry Investment Group Inc
Organization Active NPI Community/Retail Pharmacy · Crandall, TX
NPI 1144544685 · NPPES record last updated May 16, 2018
Key facts
- NPI
- 1144544685
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- License
- 26860 (TX)
- Legal business name
- KINDLE MAYBERRY INVESTMENT GROUP INC
- Practice address
- 1317 Hwy 175 Ste 800
Crandall, TX 75114 - Phone
- (972) 427-6442
- Fax
- (972) 427-6470
- NPI assigned
- Mar 25, 2010
- Organization subpart
- No
Authorized official
- Name
- Gary Mayberry
- Title
- Pharmacist
- Phone
- (972) 427-6442
Practitioners 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20181102002268 | TX | Part B Supplier - Pharmacy | 5395098677 | Practice locations: Crandall, TX |
National Provider Directory
Locations
1317 E US Highway 175
Ste 800
Crandall, TX 75114
Phone (972) 427-6442
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | 26860 | TX | Yes |
Addresses
Primary practice location
1317 Hwy 175 Ste 800
Crandall, TX 75114
Mailing address
PO Box 100
Crandall, TX 75114-0100
Phone (903) 972-6442
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2124524 | Other | PK |
Other providers in Crandall, TX
- Byron M Jefferson
- Jeshurun Home Health Services, LLC
- JMZ Positive Behavioral Outlook PLLC
- William Joukep
- Kaufman Physical Therapy and Rehabilitation
- Rachel Kwarteng
- Sharon Long
- Gary Mayberry
- Medi-Ride Solutions LLC
- Meredith a. Byington, M.D., P.a.
All providers in Crandall, TX · Community/Retail Pharmacy in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 16, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.