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General NPI Number Information
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NPI Number | 1134769888
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Entity Type | Organization
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Legal Business Name | MAO PHARMACY, INC.
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Dates
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Enumeration Date | 01/10/2020
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Last Update Date | 01/20/2020
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Provider Practice Location Address
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Address Line | 3908 NINE MILE RD RM 518
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City | RICHMOND
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State | VA
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Zip | 23223-4913
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Country | US
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Telephone | 804-767-1195
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Fax |
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Provider Business Mailing Address
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Address Line | 5823 PATTERSON AVE
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City | RICHMOND
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State | VA
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Zip | 23226-2536
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Country | US
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Telephone | 804-288-1933
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Fax |
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Authorized Official
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Title or Position | VICE PRESIDENT OF CLINICAL SERVICES
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Name | SHANNON MEADOWS DOWDY
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Credential | PHARM.D.
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Telephone | 804-288-1933
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0002X
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Taxonomy Name | Clinic Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number |
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License Number State |
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