MEDICARE: 2 M 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	333600000X	Pharmacy
2	3336C0003X	Community/Retail Pharmacy

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2128193	OTHER		PK
2	PHY59490	OTHER	CA	BOARD OF PHARMACY

General Provider Information

NPI Number	:	1851386643
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	2 M PHARMACY INC

Provider Business Mailing Address
First Line	:	2333 LAKE AVE STE D
Second Line	:
City	:	ALTADENA
State	:	CA
Zip	:	91001-6014
Country	:	US
Telephone Number	:	626-797-1163
Fax Number	:	626-791-8074

Provider Business Practice Location Address
First Line	:	2333 LAKE AVE STE D
Second Line	:
City	:	ALTADENA
State	:	CA
Zip	:	91001-6014
Country	:	US
Telephone Number	:	626-797-1163
Fax Number	:	626-791-8074

Authorized Official
Title or Position	:	PRESIDENT/CEO/PIC
Name	:	MICHAEL MILLER
Credential	:	RPH
Telephone Number	:	626-797-1163

Provider Enumeration Date	:	09/16/2005
Last Update Date	:	04/29/2024

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