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General NPI Number Information
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NPI Number | 1205245586
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Entity Type | Organization
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Legal Business Name | ATLAS MEDS PHARMACY INC
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Dates
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Enumeration Date | 08/12/2014
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Last Update Date | 02/06/2023
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Provider Practice Location Address
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Address Line | 4801 S MARTIN LUTHER KING JR BLVD
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City | LANSING
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State | MI
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Zip | 48910-5111
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Country | US
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Telephone | 517-580-0991
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Fax | 517-580-0992
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Provider Business Mailing Address
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Address Line | 4801 S MARTIN LUTHER KING JR BLVD
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City | LANSING
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State | MI
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Zip | 48910-5111
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Country | US
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Telephone | 517-580-0991
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Fax | 517-580-0992
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Authorized Official
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Title or Position | PRESIDENT
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Name | DALIA ELGOHARY
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Credential | RPH
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Telephone | 517-580-0991
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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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 | 333600000X
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Taxonomy Name | 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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Taxonomy #4
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 5301010592
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License Number State | MI
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