1144222134 NPI number — MRS. MITZI SHEREE WEEKS PHARMACIST

Table of content: MRS. MITZI SHEREE WEEKS PHARMACIST (NPI 1144222134)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1144222134 NPI number — MRS. MITZI SHEREE WEEKS PHARMACIST

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WEEKS
Provider First Name:
MITZI
Provider Middle Name:
SHEREE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
PHARMACIST
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
WEEKS
Provider Other First Name:
MITZI
Provider Other Middle Name:
SHEREE
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1144222134
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6104 AVENUE Q SOUTH DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LUBBOCK
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
79412-3700
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
806-472-3400
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6104 AVENUE Q SOUTH DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LUBBOCK
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
79412-3700
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
806-472-3400
Provider Business Practice Location Address Fax Number:
806-472-3401
Provider Enumeration Date:
08/10/2005

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 183500000X , with the licence number:  28819 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)