Momba Pharmacy Services LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PP414165L Issued in PA

Legal business name

MOMBA PHARMACY SERVICES LLC

Practice address

1234 W Main St
Monongahela, PA 15063-2830

Phone

(724) 258-5055

Fax

(724) 258-7806

NPI assigned

Dec 2, 2011

Organization subpart

No

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

Authorized official

Name

Matthew Morgan

Title

Specialist, Customer Ops Support

Phone

(614) 652-1509

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• The Medicine Shoppe Doing business as

Tax ID family

Momba Pharmacy Services LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Momba Pharmacy Services LLC

  • Long Term Care Pharmacy
  • Pittsburgh, PA
  • NPI 1407618663
  NPD tax ID

Locations

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

{
    "created_epoch": "1322784000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1340755200000",
    "number": "1275801458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1234 W MAIN ST",
            "city": "MONONGAHELA",
            "state": "PA",
            "postal_code": "150632830",
            "telephone_number": "724-258-5055",
            "fax_number": "724-258-7806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1234 W MAIN ST",
            "city": "MONONGAHELA",
            "state": "PA",
            "postal_code": "150632830",
            "telephone_number": "724-258-5055",
            "fax_number": "724-258-7806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOMBA PHARMACY SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-02",
        "last_updated": "2012-06-27",
        "status": "A",
        "authorized_official_last_name": "MORGAN",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "SPECIALIST, CUSTOMER OPS SUPPORT",
        "authorized_official_telephone_number": "614-652-1509"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "PA",
            "license": "PP414165L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "3996432",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Medicine Shoppe",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Lumei Miller, MD
• Mon City Chiropractic Clinic, PC
• Mon Vale Clinical Professionals, Inc.
• Mon Vale Clinical Professionals, Inc.
• Mon Valley Anesthesia Associates PC
• Mon Valley Dialysis Clinic, Inc.

• Community/Retail Pharmacy in Monongahela, PA
• Providers in Monongahela, PA by specialty
• Community/Retail Pharmacy in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2012; 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.