Organization Name: | MK INFUSION PHARMACY LLC |
NPI Number: | 1093179509 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MISSY MONTGOMERY (CLINICAL PHARMACIST / CEO) |
Mailing Address: | 307 W State St Muscle Shoals |
State: | AL US |
Postal Code: | 356612835 |
Phone Number: | 2563207611 |
Fax Number: | 2563207607 |
NPI Enumeration Date: | 04/11/2016 |
NPI Last Update Date: | 04/27/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332BP3500X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
Taxonomy Specialization: | Parenteral & Enteral Nutrition |
Taxonomy Definition: |