Provider Demographics
NPI:1447388707
Name:MACS PHARMACY INC
Entity Type:Organization
Organization Name:MACS PHARMACY INC
Other - Org Name:MACS PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/ PIC
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:MATTHEW
Authorized Official - Last Name:CRAWFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:865-524-3453
Mailing Address - Street 1:2419 WASHINGTON PIKE
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37917-3321
Mailing Address - Country:US
Mailing Address - Phone:865-524-3453
Mailing Address - Fax:865-524-9925
Practice Address - Street 1:2419 WASHINGTON PIKE
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37917-3321
Practice Address - Country:US
Practice Address - Phone:865-524-3453
Practice Address - Fax:865-524-9925
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-01
Last Update Date:2023-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261Q00000X, 332B00000X, 333600000X, 3336C0004X
TN20453336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2095705OtherPK
TN9449518Medicaid
2095705OtherPK