Provider Demographics
NPI:1760603864
Name:MEDICATION INFORMATION MEANS EMPOWERMENT, LLC
Entity Type:Organization
Organization Name:MEDICATION INFORMATION MEANS EMPOWERMENT, LLC
Other - Org Name:MIME, LLC
Other - Org Type:Other Name
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:GINA
Authorized Official - Middle Name:P
Authorized Official - Last Name:MCKNIGHT-SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD, MBA
Authorized Official - Phone:410-922-6542
Mailing Address - Street 1:PO BOX 953
Mailing Address - Street 2:
Mailing Address - City:RANDALLSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21133-9998
Mailing Address - Country:US
Mailing Address - Phone:410-922-6542
Mailing Address - Fax:
Practice Address - Street 1:8706 WINANDS RD
Practice Address - Street 2:
Practice Address - City:RANDALLSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21133-4036
Practice Address - Country:US
Practice Address - Phone:410-922-6542
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-02
Last Update Date:2010-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD146001835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapyGroup - Single Specialty