Mak Medical LLC

Primary specialty

Home Infusion Therapy PharmacyTaxonomy code 3336H0001X

License

PHHH000042 Issued in GA

Legal business name

MAK MEDICAL LLC

Doing business as

MAK Medical

Practice address

159 E Broad St
Camilla, GA 31730-1842

Phone

(229) 336-7758

Fax

(229) 336-5615

NPI assigned

Oct 24, 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

Ceo/ Pharmacist

Phone

(229) 336-7758

Specialties & licenses 8

Addresses

Other identifiers 2

Other names 1

• MAK Medical Doing business as

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

{
    "created_epoch": "1224806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1246233600000",
    "number": "1144473935",
    "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",
            "telephone_number": "229-336-7758",
            "fax_number": "229-336-5615"
        },
        {
            "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": "229-336-7758",
            "fax_number": "229-336-5615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAK MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-24",
        "last_updated": "2009-06-29",
        "status": "A",
        "authorized_official_last_name": "MILLSAPS",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_title_or_position": "CEO/ PHARMACIST",
        "authorized_official_telephone_number": "229-336-7758"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332BN1400X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Nursing Facility Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336H0001X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Home Infusion Therapy Pharmacy",
            "state": "GA",
            "license": "PHHH000042",
            "primary": true
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "027448369C",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "1158155",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MAK Medical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Rachel S Lauder, PT
• Barry T Leath, CRNA
• Katy L. Lewis, MS OTR/L
• Christine M Lockhart, CNP
• Staci A Mackey
• Mak Medical, LLC
• Mak Pharmacy LLC
• Ashley Nicole Maxwell, OTR/L
• Carly McCook, SLP
• Gregory McCullough

• Home Infusion Therapy Pharmacy in Camilla, GA
• Providers in Camilla, GA by specialty
• Home Infusion Therapy Pharmacy in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 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.