Provider Demographics
NPI:1023185147
Name:M D COMPANY, INC.
Entity Type:Organization
Organization Name:M D COMPANY, INC.
Other - Org Name:MD PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:MOGIL
Authorized Official - Suffix:
Authorized Official - Credentials:MCRP
Authorized Official - Phone:215-763-1875
Mailing Address - Street 1:1641 N FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19122-2903
Mailing Address - Country:US
Mailing Address - Phone:215-763-1875
Mailing Address - Fax:215-235-6897
Practice Address - Street 1:1641 N FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19122-2903
Practice Address - Country:US
Practice Address - Phone:215-763-1875
Practice Address - Fax:215-235-6897
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-30
Last Update Date:2008-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPP411628L3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA000571206002Medicaid
3929277OtherNCPDP
PA393805OtherPACE PROGRAM
PA0134400001Medicare NSC