MFM Pharmacy, LLC

Primary specialty

PharmacyTaxonomy code 333600000X

Legal business name

MFM PHARMACY, LLC

Practice address

6912 FM 1488 Rd Ste B
Magnolia, TX 77354-1527

Phone

(281) 214-4040

NPI assigned

Dec 2, 2019

Organization subpart

No

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

Authorized official

Name

Charbel Boujaoude

Title

Pharmacy Manager

Phone

(281) 214-4040

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

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

{
    "created_epoch": "1575244800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1962049627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6912 FM 1488 RD STE B",
            "city": "MAGNOLIA",
            "state": "TX",
            "postal_code": "773541527",
            "telephone_number": "281-214-4040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6912 FM 1488 RD STE B",
            "city": "MAGNOLIA",
            "state": "TX",
            "postal_code": "773541527",
            "telephone_number": "281-214-4040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MFM PHARMACY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-02",
        "last_updated": "2023-03-07",
        "certification_date": "2020-01-09",
        "status": "A",
        "authorized_official_last_name": "BOUJAOUDE",
        "authorized_official_first_name": "CHARBEL",
        "authorized_official_title_or_position": "PHARMACY MANAGER",
        "authorized_official_telephone_number": "281-214-4040"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE BOARD LICENSE",
            "identifier": "33014",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Magnolia",
            "affiliation": "N",
            "address_1": "6912 Fm 1488 Rd Ste B",
            "city": "Magnolia",
            "state": "TX",
            "country_code": "US",
            "postal_code": "773541527",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.