Provider Demographics
NPI:1346215415
Name:MAKO'S MARKET, INC.
Entity Type:Organization
Organization Name:MAKO'S MARKET, INC.
Other - Org Name:MAKO'S PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:AUBIHL
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:740-922-5400
Mailing Address - Street 1:240 E 3RD ST
Mailing Address - Street 2:
Mailing Address - City:UHRICHSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44683-1821
Mailing Address - Country:US
Mailing Address - Phone:740-922-5400
Mailing Address - Fax:740-922-3300
Practice Address - Street 1:240 E 3RD ST
Practice Address - Street 2:
Practice Address - City:UHRICHSVILLE
Practice Address - State:OH
Practice Address - Zip Code:44683-1821
Practice Address - Country:US
Practice Address - Phone:740-922-5400
Practice Address - Fax:740-922-3300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-21
Last Update Date:2021-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH02863100333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0169204Medicaid
OH154790001Medicare ID - Type Unspecified
OH0169204Medicaid