Provider Demographics
NPI:1811918881
Name:M AND M PHARMACIES INC
Entity type:Organization
Organization Name:M AND M PHARMACIES INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:MESSALI
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:619-442-0417
Mailing Address - Street 1:248 AVOCADO AVE
Mailing Address - Street 2:
Mailing Address - City:EL CAJON
Mailing Address - State:CA
Mailing Address - Zip Code:92020-4604
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:248 AVOCADO AVE
Practice Address - Street 2:
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92020-4604
Practice Address - Country:US
Practice Address - Phone:619-442-0417
Practice Address - Fax:619-442-0427
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPHY41992333600000X
3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered333600000XSuppliersPharmacy
Not Answered3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
0531550OtherOTHER ID NUMBER-COMMERCIAL NUMBER
CAPHA419920Medicaid
0531550OtherOTHER ID NUMBER-COMMERCIAL NUMBER