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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 | Specialty Code | Provider Type | |
Managed Care Organization Pharmacy |
3336M0003X | 58 | Medical Supply Company with Pharmacist | |
Community/Retail Pharmacy |
3336C0003X | 58 | Medical Supply Company with Pharmacist | |
Long Term Care Pharmacy |
3336L0003X | 58 | Medical Supply Company with Pharmacist | |
Pharmacy |
333600000X | 58 | Medical Supply Company with Pharmacist |
| NPI # | 1992710594 |
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| LBN Legal business name | AUTELL PHARMACY INC | ||||||||||||
| Authorized official | MARY AUTELL - (TREASURER) | ||||||||||||
| Entity | Organization | ||||||||||||
| Organization subpart 1 | No | ||||||||||||
| Enumeration date | 07/30/2006 | ||||||||||||
| Last updated | 09/11/2025 - About 9 months ago | ||||||||||||
| Identifiers |
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AUTELL PHARMACY INC
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AUTELL PHARMACY INC