Provider Demographics
NPI:1093087090
Name:M&E PHARMACY SERVICES INC
Entity Type:Organization
Organization Name:M&E PHARMACY SERVICES INC
Other - Org Name:MEDICAL ARTS PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ITEOGU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:478-957-3370
Mailing Address - Street 1:1193 FORSYTH ST
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31201-1735
Mailing Address - Country:US
Mailing Address - Phone:478-746-8331
Mailing Address - Fax:478-254-8926
Practice Address - Street 1:1193 FORSYTH ST
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31201-1735
Practice Address - Country:US
Practice Address - Phone:478-746-8331
Practice Address - Fax:478-254-8926
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-07
Last Update Date:2017-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
GAPHRE0098093336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00312196AMedicaid
2133761OtherPK