A pharmacy owned by a managed care organization (MCO) used by pharmacists for the compounding and dispensing of medicinal preparations to that MCO?s covered members only.
| Specialty | Taxonomy Code | |
|---|---|---|
| * | Managed Care Organization Pharmacy | 3336M0003X |
* Indicates primary specialty
| NPI Number | 1104762590 |
| Credentials | PHARMD (Doctor of Pharmacy) |
| Entity | Individual |
| Enumeration date | 04/27/2026 |
| Last updated | 04/27/2026 - About a month ago |
| Sole proprietor1 | Yes |
| Identifiers | n/a |
| Hospital affiliation | n/a |
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.
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