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General NPI Number Information
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NPI Number | 1023185147
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Entity Type | Organization
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Legal Business Name | M D COMPANY, INC.
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Dates
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Enumeration Date | 11/30/2006
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Last Update Date | 02/25/2008
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Provider Practice Location Address
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Address Line | 1641 N FRANKLIN ST
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City | PHILADELPHIA
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State | PA
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Zip | 19122-2903
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Country | US
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Telephone | 215-763-1875
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Fax | 215-235-6897
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Provider Business Mailing Address
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Address Line | 1641 N FRANKLIN ST
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City | PHILADELPHIA
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State | PA
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Zip | 19122-2903
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Country | US
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Telephone | 215-763-1875
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Fax | 215-235-6897
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MARK MOGIL
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Credential | MCRP
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Telephone | 215-763-1875
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PP411628L
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License Number State | PA
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