Mak Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHRE009536 Issued in GA

Legal business name

MAK PHARMACY LLC

Doing business as

MAK PHARMACY

Practice address

159 E Broad St
Camilla, GA 31730-1842

Phone

(229) 336-7654

Fax

(229) 336-5615

NPI assigned

Nov 19, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Elizabeth Millsaps

Title

Pharmacist/Ceo

Phone

(229) 336-7654

Specialties & licenses 4

Addresses

Other identifiers 2

Other names 1

• MAK PHARMACY Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1227052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1236556800000",
    "number": "1023263977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 394",
            "city": "CAMILLA",
            "state": "GA",
            "postal_code": "317300394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "159 E BROAD ST",
            "city": "CAMILLA",
            "state": "GA",
            "postal_code": "317301842",
            "telephone_number": "229-336-7654",
            "fax_number": "229-336-5615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAK PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-19",
        "last_updated": "2009-03-09",
        "status": "A",
        "authorized_official_last_name": "MILLSAPS",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_title_or_position": "PHARMACIST/CEO",
        "authorized_official_telephone_number": "229-336-7654"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "GA",
            "license": "PHRE009536",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "1158167",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "027448369A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MAK PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Katy L. Lewis, MS OTR/L
• Christine M Lockhart, CNP
• Staci A Mackey
• Mak Medical LLC
• Mak Medical, LLC
• Ashley Nicole Maxwell, OTR/L
• Carly McCook, SLP
• Gregory McCullough
• Shaytoria Janea McDuffie, CNA
• Joseph Charles McGalliard, RPH

• Community/Retail Pharmacy in Camilla, GA
• Providers in Camilla, GA by specialty
• Community/Retail Pharmacy in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.