| NPI | 1861752339 |
|---|---|
| Doing Business As | MAC'S LTC PHARMACY |
| Entity Type | Organization |
| Authorized Contact | LORI BURGESS Pharmacist 276-525-4357 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy, Long Term Care Pharmacy (Licence: VA 0201004458) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2012-05-18 |
| Last Update Date | 2017-01-13 |