Organization
M & M DRUG CO
Active
Other names
Mark's Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MARK WILLIAMS BS (THIRD PARTY PLAN COORDINATOR)
(913) 262-5553
Entity
Organization
Contact information
Practice address
4501 RAINBOW BLVD, KANSAS CITY, KS 66103-3428
(913) 262-5553
(913) 262-4408
Mailing address
4501 RAINBOW BLVD, KANSAS CITY, KS 66103-3428
(913) 262-5553
(913) 262-4408
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
208709
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100443820A
—
KS
05
—
100443820B
—
KS
01
—
1714105
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
603176108
—
MO
Enumeration date
11/15/2006
Last updated
01/19/2010
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