Provider Demographics
NPI:1508613688
Name:CLEVELAND MEDICAL ARTS PHARMACY INC
Entity type:Organization
Organization Name:CLEVELAND MEDICAL ARTS PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GUY
Authorized Official - Middle Name:M
Authorized Official - Last Name:PHILLIPS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:662-207-0616
Mailing Address - Street 1:810 E SUNFLOWER RD STE 100D
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:MS
Mailing Address - Zip Code:38732-2828
Mailing Address - Country:US
Mailing Address - Phone:662-843-4214
Mailing Address - Fax:662-843-3398
Practice Address - Street 1:810 E SUNFLOWER RD STE 100D
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:MS
Practice Address - Zip Code:38732-2828
Practice Address - Country:US
Practice Address - Phone:662-843-4214
Practice Address - Fax:662-843-3398
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-06
Last Update Date:2024-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy