Organization Name: | MAS PHARMACY AND COMPOUNDING LAB LLC |
NPI Number: | 1235318189 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | VERA MOUMAH (PRESIDENT) |
Mailing Address: | 705 S Gordon Rd Sw Ste A Mableton |
State: | GA US |
Postal Code: | 301265138 |
Phone Number: | 7707329342 |
Fax Number: | 7707329347 |
NPI Enumeration Date: | 10/29/2007 |
NPI Last Update Date: | 04/08/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332B00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
Taxonomy Specialization: | |
Taxonomy Definition: | A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient |