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Organization

MK INFUSION PHARMACY LLC

Active
Other names
MK Infusion Pharmacy, LLC.
Organization subpart
No

Provider details

NPI number
Authorized official
MISSY MONTGOMERY PHARM.D. (CLINICAL PHARMACIST / CEO)
(256) 320-7611
Entity
Organization

Contact information

Practice address
307 W STATE ST, MUSCLE SHOALS, AL 35661-2835
(256) 320-7611
(256) 320-7607
Mailing address
307 W STATE ST, MUSCLE SHOALS, AL 35661-2835
(256) 320-7611
(256) 320-7607

Taxonomy

Speciality
Code
Description
License number
State
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
14795/7.1
MS
333600000X
Pharmacy
0000005791
TN
3336H0001X
Home Infusion Therapy Pharmacy
Primary
114617
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
187872
AL
01
2159515
PK
Enumeration date
04/11/2016
Last updated
12/15/2020
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