MDM Pharmacy Services LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

51439 Issued in CA

Legal business name

MDM PHARMACY SERVICES LLC

Doing business as

New Pharmacy

Practice address

57725 29 Palms Hwy Ste 209
Yucca Valley, CA 92284-3044

Phone

(760) 228-1600

NPI assigned

May 9, 2013

Organization subpart

No

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

Authorized official

Name

Maher Michail

Title

Pharmacist in Charge / Owner

Phone

(760) 851-8120

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• New Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in CA2 enrollments

Enrollment records 2

Tax ID family

MDM 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.

• MDM Pharmacy Services LLC

  • Long Term Care Pharmacy
  • Yucca Valley, CA
  • NPI 1720824659
  NPD tax ID

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

{
    "created_epoch": "1368057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719705600000",
    "number": "1801231428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "57725 29 PALMS HWY",
            "address_2": "SUITE 209",
            "city": "YUCCA VALLEY",
            "state": "CA",
            "postal_code": "922843044",
            "telephone_number": "760-228-1600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57725 29 PALMS HWY STE 209",
            "city": "YUCCA VALLEY",
            "state": "CA",
            "postal_code": "922843044",
            "telephone_number": "760-228-1600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MDM PHARMACY SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-09",
        "last_updated": "2024-06-30",
        "certification_date": "2024-06-30",
        "status": "A",
        "authorized_official_last_name": "MICHAIL",
        "authorized_official_first_name": "MAHER",
        "authorized_official_title_or_position": "PHARMACIST IN CHARGE / OWNER",
        "authorized_official_telephone_number": "760-851-8120"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "51439",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2140258",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "New Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Donna M. McGee
• Gregory Joel McGuinn, PA-C
• Sharon D McIntosh
• Lucenther Cynthia McKethan
• MDM Pharmacy Services LLC
• Kathleen Jayo Meads, MFT INTERN
• Medi-Source Equipment & Supply Inc
• Medical Specialty Center
• Medical Specialty Center
• Medicine Woman Chiropractic for Women

• Community/Retail Pharmacy in Yucca Valley, CA
• Providers in Yucca Valley, CA by specialty
• Community/Retail Pharmacy in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.