Provider Demographics
NPI:1477566321
Name:MAM ENTERPRISES INC
Entity Type:Organization
Organization Name:MAM ENTERPRISES INC
Other - Org Name:ARCH STREET PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:MCMURRY
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:501-261-7181
Mailing Address - Street 1:11200 ARCH ST
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72206-4649
Mailing Address - Country:US
Mailing Address - Phone:501-261-7181
Mailing Address - Fax:501-261-7307
Practice Address - Street 1:11200 ARCH ST
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72206-4649
Practice Address - Country:US
Practice Address - Phone:501-261-7181
Practice Address - Fax:501-261-7307
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-14
Last Update Date:2011-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
4420630001Medicare NSC