Provider Demographics
NPI:1548041130
Name:M&M PHARMACY LLC
Entity type:Organization
Organization Name:M&M PHARMACY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST-IN-CHARGE
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:A
Authorized Official - Last Name:MAYEUX
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:318-354-1554
Mailing Address - Street 1:311 DIXIE PLZ
Mailing Address - Street 2:
Mailing Address - City:NATCHITOCHES
Mailing Address - State:LA
Mailing Address - Zip Code:71457-5880
Mailing Address - Country:US
Mailing Address - Phone:318-354-1554
Mailing Address - Fax:318-352-1559
Practice Address - Street 1:311 DIXIE PLZ
Practice Address - Street 2:
Practice Address - City:NATCHITOCHES
Practice Address - State:LA
Practice Address - Zip Code:71457-5880
Practice Address - Country:US
Practice Address - Phone:318-354-1554
Practice Address - Fax:318-352-1559
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:M&M PHARMACY, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-10-10
Last Update Date:2023-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy