Medicine Chest 114 LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

26182 Issued in TX

Legal business name

MEDICINE CHEST 114 LLC

Doing business as

Goods Medicine Chest

Practice address

807 S Beckham Ave
Suite 100
Tyler, TX 75701-1905

Phone

(903) 592-8283

Fax

(903) 885-1024

NPI assigned

Sep 12, 2005

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Chad Michel

Title

Ceo

Phone

(903) 885-0821

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• GOODS MEDICINE CHEST Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1126483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1435795200000",
    "number": "1497749915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6397",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757116397",
            "telephone_number": "903-885-0821",
            "fax_number": "903-885-1024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "807 S BECKHAM AVE",
            "address_2": "SUITE 100",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757011905",
            "telephone_number": "903-592-8283",
            "fax_number": "903-885-1024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICINE CHEST 114 LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-12",
        "last_updated": "2015-07-02",
        "status": "A",
        "authorized_official_last_name": "MICHEL",
        "authorized_official_first_name": "CHAD",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "903-885-0821"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "TX",
            "license": "26182",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "466551",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2102545",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GOODS MEDICINE CHEST",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Meals on Wheels Ministry, Inc. (Meals on Wheels of East Texas)
• Neva Land Mebane, DO
• Med Southwest, PLLC (MyEyeDr.)
• Frederico Diego Medeiros Lima, DDS
• Michelle Phi Medel, M.D.
• Nelida Medina-Perez, LCSW
• Alicia Medina
• Cristina Medina
• Maria Claudia Medina, LVN
• Stephanie Medina

• Community/Retail Pharmacy in Tyler, TX
• Providers in Tyler, TX by specialty
• Community/Retail Pharmacy in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 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.

Verify at the official NPI Registry.