Provider Demographics
NPI:1942719398
Name:MKST MANAGEMENT, LLC RXWAY PHARMACY
Entity Type:Organization
Organization Name:MKST MANAGEMENT, LLC RXWAY PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACY OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:T
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMACIST
Authorized Official - Phone:407-203-3805
Mailing Address - Street 1:448 S ALAFAYA TRL STE 2
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32828-8998
Mailing Address - Country:US
Mailing Address - Phone:407-203-3805
Mailing Address - Fax:407-203-4784
Practice Address - Street 1:448 SOUTH ALAFAYA TRAIL
Practice Address - Street 2:SUITE 2
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32828-8998
Practice Address - Country:US
Practice Address - Phone:407-203-3805
Practice Address - Fax:407-203-4784
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-28
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH308233336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy