Provider Demographics
NPI:1811052202
Name:M AND T ENTERPRISES, INC.
Entity type:Organization
Organization Name:M AND T ENTERPRISES, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST / OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:PALMER
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:530-532-9555
Mailing Address - Street 1:2445 OROVILLE DAM BLVD
Mailing Address - Street 2:SUITE 9
Mailing Address - City:OROVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95966
Mailing Address - Country:US
Mailing Address - Phone:530-532-9555
Mailing Address - Fax:530-534-1436
Practice Address - Street 1:2445 OROVILLE DAM BOULEVARD
Practice Address - Street 2:SUITE 9
Practice Address - City:OROVILLE
Practice Address - State:CA
Practice Address - Zip Code:95966
Practice Address - Country:US
Practice Address - Phone:530-532-9555
Practice Address - Fax:530-534-1436
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-26
Last Update Date:2008-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA36865183500000X, 3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPHA328600Medicaid
CA2278114OtherMEDI-CAL
CAPHA328600Medicaid