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Organization

MAK MEDICAL LLC

Active
Other names
MAK Medical
Organization subpart
No

Provider details

NPI number
Authorized official
ELIZABETH MILLSAPS (CEO/ PHARMACIST)
(229) 336-7758
Entity
Organization

Contact information

Practice address
159 E BROAD ST, CAMILLA, GA 31730-1842
(229) 336-7758
(229) 336-5615
Mailing address
PO BOX 394, CAMILLA, GA 31730-0394
(229) 336-7758
(229) 336-5615

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
251J00000X
Nursing Care Agency
332B00000X
Durable Medical Equipment & Medical Supplies
332BN1400X
Nursing Facility Supplies (DME)
333600000X
Pharmacy
3336C0004X
Compounding Pharmacy
3336H0001X
Home Infusion Therapy Pharmacy
Primary
PHHH000042
GA
3336S0011X
Specialty Pharmacy

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
027448369C
GA
01
1158155
NCPDP PROVIDER IDENTIFICATION NUMBER
Enumeration date
10/24/2008
Last updated
06/29/2009
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