Provider Demographics
NPI:1932501038
Name:MBP GROUP, LLC
Entity Type:Organization
Organization Name:MBP GROUP, LLC
Other - Org Name:EPIC SPECIALTY PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PIC
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:PLAISANCE
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:504-324-4343
Mailing Address - Street 1:8138 OAK ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70118-2040
Mailing Address - Country:US
Mailing Address - Phone:504-324-4343
Mailing Address - Fax:504-301-2950
Practice Address - Street 1:8138 OAK ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70118
Practice Address - Country:US
Practice Address - Phone:504-324-4343
Practice Address - Fax:504-301-2950
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-19
Last Update Date:2018-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy