Provider Demographics
NPI:1568087823
Name:MEDSPACK MAIL ORDER
Entity Type:Organization
Organization Name:MEDSPACK MAIL ORDER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:PRAMOD
Authorized Official - Middle Name:K
Authorized Official - Last Name:ARIKERI
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:877-982-8595
Mailing Address - Street 1:5006 E TRINDLE RD STE 103A
Mailing Address - Street 2:
Mailing Address - City:MECHANICSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17050-3647
Mailing Address - Country:US
Mailing Address - Phone:877-982-8595
Mailing Address - Fax:877-772-9989
Practice Address - Street 1:5006 E TRINDLE RD STE 103A
Practice Address - Street 2:
Practice Address - City:MECHANICSBURG
Practice Address - State:PA
Practice Address - Zip Code:17050-3647
Practice Address - Country:US
Practice Address - Phone:877-982-8595
Practice Address - Fax:877-772-9989
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-12
Last Update Date:2020-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No3336M0002XSuppliersPharmacyMail Order Pharmacy