Mas Pharmacy and Compounding Lab LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHRE009151 Issued in GA

Legal business name

MAS PHARMACY AND COMPOUNDING LAB LLC

Practice address

705 S Gordon Rd SW
Ste a
Mableton, GA 30126-5138

Phone

(770) 732-9342

Fax

(770) 732-9347

NPI assigned

Oct 29, 2007

Organization subpart

No

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

Authorized official

Name

Vera Moumah

Title

President

Phone

(770) 732-9342

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• MAS PHARMACY AND COMPOUNDING LAB LLC Doing business as

Locations

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

{
    "created_epoch": "1193616000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207612800000",
    "number": "1235318189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 S GORDON RD SW",
            "address_2": "STE A",
            "city": "MABLETON",
            "state": "GA",
            "postal_code": "301265138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 S GORDON RD SW",
            "address_2": "STE A",
            "city": "MABLETON",
            "state": "GA",
            "postal_code": "301265138",
            "telephone_number": "770-732-9342",
            "fax_number": "770-732-9347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAS PHARMACY AND COMPOUNDING LAB LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-29",
        "last_updated": "2008-04-08",
        "status": "A",
        "authorized_official_last_name": "MOUMAH",
        "authorized_official_first_name": "VERA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "770-732-9342"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "GA",
            "license": "PHRE009151",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER",
            "identifier": "1156466",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MAS PHARMACY AND COMPOUNDING LAB LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Mableton, GA
• Providers in Mableton, 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 Apr 8, 2008; 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.