Provider Demographics
NPI:1124213640
Name:MFP, LTD.
Entity Type:Organization
Organization Name:MFP, LTD.
Other - Org Name:PRESCRIPTION LAB COMPOUNDING PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:NICOLETTI
Authorized Official - Suffix:
Authorized Official - Credentials:RPH,CCN,FIACP,FACA
Authorized Official - Phone:520-886-1035
Mailing Address - Street 1:6586 E GRANT RD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85715-3801
Mailing Address - Country:US
Mailing Address - Phone:520-886-1035
Mailing Address - Fax:520-886-3548
Practice Address - Street 1:6586 E GRANT RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85715-3801
Practice Address - Country:US
Practice Address - Phone:520-886-1035
Practice Address - Fax:520-886-3548
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-07
Last Update Date:2007-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZY02793261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center