Organization Name: | MAC'S MEDICINE MART, INC |
NPI Number: | 1760580609 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | BARRY WALTON (PRESIDENT) |
Mailing Address: | 1425 E Center St Kingsport |
State: | TN US |
Postal Code: | 376642501 |
Phone Number: | 4232452181 |
Fax Number: | 4232457261 |
NPI Enumeration Date: | 09/21/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332B00000X |
License Number: | 0417510001 |
Healthcare Provider Taxonomy: (Secondary) | X |
State: | TN |
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 |