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General NPI Number Information
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NPI Number | 1508711748
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Entity Type | Organization
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Legal Business Name | M1VM
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Dates
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Enumeration Date | 03/03/2026
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Last Update Date | 03/03/2026
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Provider Practice Location Address
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Address Line | 2527 CHURCH AVE APT 1B
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City | BROOKLYN
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State | NY
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Zip | 11226-4570
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Country | US
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Telephone | 754-778-2976
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Fax |
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Provider Business Mailing Address
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Address Line | 10402 S 84TH AVE
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City | PALOS HILLS
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State | IL
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Zip | 60465-1704
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Country | US
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Telephone | 754-778-2976
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | KAREEM J MCRAE
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Credential |
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Telephone | 754-778-2976
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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 |
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License Number State |
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