Organization
MAK MEDICAL LLC
Active
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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