Provider Demographics
NPI:1760586721
Name:MEDICAL ARTS PHARMACY INC OF FOREST CITY
Entity Type:Organization
Organization Name:MEDICAL ARTS PHARMACY INC OF FOREST CITY
Other - Org Name:MEDICAL ARTS PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:LAMB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-245-7294
Mailing Address - Street 1:924 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FOREST CITY
Mailing Address - State:NC
Mailing Address - Zip Code:28043-2518
Mailing Address - Country:US
Mailing Address - Phone:828-245-7294
Mailing Address - Fax:828-245-2406
Practice Address - Street 1:924 W MAIN ST
Practice Address - Street 2:
Practice Address - City:FOREST CITY
Practice Address - State:NC
Practice Address - Zip Code:28043-2518
Practice Address - Country:US
Practice Address - Phone:828-245-7294
Practice Address - Fax:828-245-2406
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-12
Last Update Date:2016-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
NC075433336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2067798OtherPK
NC0815175Medicaid
2067798OtherPK