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NPI Code Detail

MEDICARE: MAO PHARMACY, INC.

MEDICARE: MAO PHARMACY, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
13336C0002XClinic Pharmacy
23336C0003XCommunity/Retail Pharmacy
33336L0003XLong Term Care Pharmacy

General Provider Information

NPI Number : 1134769888
Entity Type Code : Organization
Provider Name (Legal Business Name) : MAO PHARMACY, INC.
Provider Business Mailing Address
First Line : 5823 PATTERSON AVE
Second Line :
City : RICHMOND
State : VA
Zip : 23226-2536
Country : US
Telephone Number : 804-288-1933
Fax Number :
Provider Business Practice Location Address
First Line : 3908 NINE MILE RD RM 518
Second Line :
City : RICHMOND
State : VA
Zip : 23223-4913
Country : US
Telephone Number : 804-767-1195
Fax Number :
Authorized Official
Title or Position : VICE PRESIDENT OF CLINICAL SERVICES
Name : SHANNON MEADOWS DOWDY
Credential : PHARM.D.
Telephone Number : 804-288-1933
Provider Enumeration Date : 01/10/2020
Last Update Date : 01/20/2020

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