Organization
MDM PHARMACY SERVICES LLC
Active
Organization
MDM PHARMACY SERVICES LLC
Active
Other names
New Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MAHER MICHAIL (PHARMACIST IN CHARGE / OWNER)
(760) 851-8120
Entity
Organization
Contact information
Practice address
57725 29 PALMS HWY STE 209, YUCCA VALLEY, CA 92284-3044
(760) 228-1600
Mailing address
57725 29 PALMS HWY, SUITE 209, YUCCA VALLEY, CA 92284-3044
(760) 228-1600
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
51439
CA
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2140258
PK
—
Enumeration date
05/09/2013
Last updated
06/30/2024
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