Provider Demographics
NPI:1982263950
Name:MEKASON PHARMACY GREENWOOD, INC
Entity type:Organization
Organization Name:MEKASON PHARMACY GREENWOOD, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:EMEKA
Authorized Official - Middle Name:
Authorized Official - Last Name:ONYEMETU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:432-210-0733
Mailing Address - Street 1:1805 S COUNTY RD 1105
Mailing Address - Street 2:SUITE C
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79706
Mailing Address - Country:US
Mailing Address - Phone:432-682-3100
Mailing Address - Fax:
Practice Address - Street 1:1805 S COUNTY RD 1105
Practice Address - Street 2:SUITE C
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79706
Practice Address - Country:US
Practice Address - Phone:432-682-3100
Practice Address - Fax:432-682-3200
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MEKASON PHARMACY , INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-06-12
Last Update Date:2019-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy