# MAS PHARMACY AND COMPOUNDING LAB LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** MAS PHARMACY AND COMPOUNDING LAB LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1235318189
- **Authorized official:** VERA MOUMAH (PRESIDENT)
- **Authorized official phone:** (770) 732-9342

## Contact information

- **Practice address:** 705 S GORDON RD SW, STE A, MABLETON, GA 30126-5138
- **Practice address phone:** (770) 732-9342
- **Practice address fax:** (770) 732-9347
- **Mailing address:** 705 S GORDON RD SW, STE A, MABLETON, GA 30126-5138

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | PHRE009151 | GA | Yes |

## Other

- **Enumeration date:** 10/29/2007
- **Last updated:** 04/08/2008