Healthcare Provider Details

I. General information

NPI: 1114991114
Provider Name (Legal Business Name): MMRX, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/15/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

408 E NORTH 1ST ST
SENECA SC
29678-2742
US

IV. Provider business mailing address

408 E NORTH 1ST ST
SENECA SC
29678-2742
US

V. Phone/Fax

Practice location:
  • Phone: 864-885-0548
  • Fax: 864-885-0080
Mailing address:
  • Phone: 864-885-0548
  • Fax: 864-885-0080

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number50-002396
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number50-002396
License Number StateSC
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number50-002396
License Number StateSC

VIII. Authorized Official

Name: MICHAEL A. MUIR
Title or Position: PRESIDENT
Credential: R.PH.
Phone: 864-885-0548