Provider Demographics
NPI:1447819479
Name:DMB HEALTH AT CORPUS LLC
Entity type:Organization
Organization Name:DMB HEALTH AT CORPUS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:RAMANA
Authorized Official - Middle Name:
Authorized Official - Last Name:MANDADI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:361-345-4656
Mailing Address - Street 1:1311 S STAPLES ST
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78404-3120
Mailing Address - Country:US
Mailing Address - Phone:361-414-9745
Mailing Address - Fax:361-345-4647
Practice Address - Street 1:1314 S STAPLES ST
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78404-3121
Practice Address - Country:US
Practice Address - Phone:361-345-4646
Practice Address - Fax:361-345-4647
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-12
Last Update Date:2024-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy