Provider Demographics
NPI:1871211268
Name:MPN3 PHARMACY MGT LLC
Entity type:Organization
Organization Name:MPN3 PHARMACY MGT LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:MINA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-318-9628
Mailing Address - Street 1:1 JEAN CT
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:NJ
Mailing Address - Zip Code:08873-7337
Mailing Address - Country:US
Mailing Address - Phone:732-318-9628
Mailing Address - Fax:
Practice Address - Street 1:1411 MEDICAL PKWY STE 101
Practice Address - Street 2:
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613-2696
Practice Address - Country:US
Practice Address - Phone:512-399-5958
Practice Address - Fax:512-399-5953
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-22
Last Update Date:2022-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy