Active NPI
Mal Enterprises Inc
Doing business as Serenity Park Pharmacy
- Community/Retail Pharmacy
- McCamey, TX
National Provider Identifier
1235140724
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- 26724
- Legal business name
- MAL ENTERPRISES INC
- Doing business as
- Serenity Park Pharmacy
- Practice address
- 507 S. Burleson Ave.
McCamey, TX 79752 - Phone
- (325) 884-2579
- Fax
- (325) 884-3234
- NPI assigned
- Aug 10, 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
- Neal Hoover
- Title
- Treasurer-Controller
- Phone
- (235) 236-6351
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | 26724 | TX | Primary |
Addresses
Primary practice location
507 S. Burleson Ave.
McCamey, TX 79752
Mailing address
PO Box 8
Sweetwater, TX 79556-0008
Phone (325) 236-6351
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2123721 | Other | PK | |
| 466659 | Medicaid | TX |
Other names 1
- Serenity Park Pharmacy
National Provider Directory
National Provider Directory- Tax ID family
- Mal Enterprises Inc
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Pharmacist
- Winters, TX
- NPI 1891872024
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155168000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1450137600000",
"number": "1235140724",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 8",
"city": "SWEETWATER",
"state": "TX",
"postal_code": "795560008",
"telephone_number": "325-236-6351",
"fax_number": "325-236-6336"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "507 S. BURLESON AVE.",
"city": "MCCAMEY",
"state": "TX",
"postal_code": "79752",
"telephone_number": "325-884-2579",
"fax_number": "325-884-3234"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MAL ENTERPRISES INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-08-10",
"last_updated": "2015-12-15",
"status": "A",
"authorized_official_last_name": "HOOVER",
"authorized_official_first_name": "NEAL",
"authorized_official_title_or_position": "TREASURER-CONTROLLER",
"authorized_official_telephone_number": "235-236-6351"
},
"taxonomies": [
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": null,
"license": null,
"primary": false
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "TX",
"license": "26724",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PK",
"identifier": "2123721",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "466659",
"state": "TX"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Serenity Park Pharmacy",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in McCamey, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.