Provider Demographics
NPI:1528814688
Name:GETACHEW, MEDHIN (PHARM D)
Entity type:Individual
Prefix:
First Name:MEDHIN
Middle Name:
Last Name:GETACHEW
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:476 I 30 E
Mailing Address - Street 2:
Mailing Address - City:ROYSE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:75189-7527
Mailing Address - Country:US
Mailing Address - Phone:972-635-2470
Mailing Address - Fax:
Practice Address - Street 1:476 I 30 E
Practice Address - Street 2:
Practice Address - City:ROYSE CITY
Practice Address - State:TX
Practice Address - Zip Code:75189-7527
Practice Address - Country:US
Practice Address - Phone:972-635-2470
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-29
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX62314183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist