Provider Demographics
NPI:1578102042
Name:MAAA LLC
Entity Type:Organization
Organization Name:MAAA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RONAK
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-228-0268
Mailing Address - Street 1:8437 CHARLOTTE HWY
Mailing Address - Street 2:
Mailing Address - City:INDIAN LAND
Mailing Address - State:SC
Mailing Address - Zip Code:29707-7587
Mailing Address - Country:US
Mailing Address - Phone:803-228-0268
Mailing Address - Fax:803-228-3580
Practice Address - Street 1:8437 CHARLOTTE HWY
Practice Address - Street 2:
Practice Address - City:INDIAN LAND
Practice Address - State:SC
Practice Address - Zip Code:29707-7587
Practice Address - Country:US
Practice Address - Phone:803-228-0268
Practice Address - Fax:803-228-3580
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-02
Last Update Date:2020-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy