Mpt Pharmacy Llc

LBN: Mpt Pharmacy Llc
Mpt Pharmacy Llc is an health care organization with primary practice located at 170 John Randolph Dr , Hoschton GA 30548-1502. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy, Suppliers / Compounding Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Mpt Pharmacy Llc can be contacted via phone (706) 658-0064, or through Rainey, Ross via phone (706) 658-0064.

Contact Information

Primary practice address
170 John Randolph Dr Hoschton GA 30548-1502
Phone: (706) 658-0064
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Rainey, Ross PHARM.D.
Phone: (706) 658-0064

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X PHRE010068 Georgia
Suppliers / Compounding Pharmacy 3336C0004X

Profile Details

NPI number 1073922670
LBN Legal business name Mpt Pharmacy Llc
DBA Doing business as
Authorized official Rainey, Ross PHARM.D.
Entity Organization
Organization subpart 1 No
Enumeration date Aug 7th, 2014
Last updated Jan 15th, 2020 - about 6 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1073922670 NPPES
Georgia MEDICAID 003149971A
Georgia Other 2147287

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