Provider Demographics
NPI:1508249137
Name:MBS PHARMA CARE, INC.
Entity Type:Organization
Organization Name:MBS PHARMA CARE, INC.
Other - Org Name:MBS PHARMA CARE
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:BOTROS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-372-0627
Mailing Address - Street 1:1035B PROVIDENCE RD
Mailing Address - Street 2:
Mailing Address - City:WHITINSVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:01588-2121
Mailing Address - Country:US
Mailing Address - Phone:508-372-0627
Mailing Address - Fax:508-372-1607
Practice Address - Street 1:1035B PROVIDENCE RD
Practice Address - Street 2:
Practice Address - City:WHITINSVILLE
Practice Address - State:MA
Practice Address - Zip Code:01588-2121
Practice Address - Country:US
Practice Address - Phone:508-372-0627
Practice Address - Fax:508-372-1607
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-01
Last Update Date:2015-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA899683336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2152807OtherPK