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General NPI Number Information
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NPI Number | 1336236520
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Entity Type | Organization
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Legal Business Name | M & M PHARMACY INC
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Dates
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Enumeration Date | 10/07/2006
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Last Update Date | 04/19/2012
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Provider Practice Location Address
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Address Line | 7571 RITCHIE HWY
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City | GLEN BURNIE
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State | MD
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Zip | 21061-3716
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Country | US
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Telephone | 410-761-3443
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Fax | 410-590-1986
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Provider Business Mailing Address
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Address Line | 7571 RITCHIE HWY
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City | GLEN BURNIE
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State | MD
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Zip | 21061-3716
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PIC
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Name | PRASAD MATTUPALLI
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Credential |
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Telephone | 410-761-3443
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | P00021
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License Number State | MD
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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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