MEDICARE: MEDICAL ARTS PHARMACY INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336C0003X	Community/Retail Pharmacy	107320	AL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1477692184
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEDICAL ARTS PHARMACY INC

Provider Business Mailing Address
First Line	:	121 N 20TH ST
Second Line	:	BLD 1
City	:	OPELIKA
State	:	AL
Zip	:	36801-5454
Country	:	US
Telephone Number	:	334-745-5756
Fax Number	:	334-749-2102

Provider Business Practice Location Address
First Line	:	121 N 20TH ST
Second Line	:	BLD 1
City	:	OPELIKA
State	:	AL
Zip	:	36801-5454
Country	:	US
Telephone Number	:	334-745-5756
Fax Number	:	334-749-2102

Authorized Official
Title or Position	:	OWNER
Name	:	DENNIS EDWARD MILLER
Credential	:	RPH
Telephone Number	:	334-745-5756

Provider Enumeration Date	:	02/06/2007
Last Update Date	:	03/29/2011

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Directions to “MEDICAL ARTS PHARMACY INC ” Practice Location

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