Healthcare Provider Details

I. General information

NPI: 1194719096
Provider Name (Legal Business Name): MCS PHARMACEUTICS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/07/2005
Last Update Date: 03/06/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

435 LAKOTA DR
CADIZ KY
42211-6107
US

IV. Provider business mailing address

435 LAKOTA DR
CADIZ KY
42211-6107
US

V. Phone/Fax

Practice location:
  • Phone: 270-522-3441
  • Fax: 270-522-1616
Mailing address:
  • Phone: 270-522-3441
  • Fax: 270-522-1616

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number9113
License Number StateKY

VIII. Authorized Official

Name: MARY CATHERINE SMITH
Title or Position: OWNER/PRESIDENT
Credential:
Phone: 270-522-3441