Provider Demographics
NPI:1841066628
Name:MP PHARMACY 2 CORP
Entity type:Organization
Organization Name:MP PHARMACY 2 CORP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARIO
Authorized Official - Middle Name:
Authorized Official - Last Name:MENDOZA
Authorized Official - Suffix:
Authorized Official - Credentials:TECHNICIAN
Authorized Official - Phone:530-923-7900
Mailing Address - Street 1:4979 OLIVEHURST AVE
Mailing Address - Street 2:
Mailing Address - City:OLIVEHURST
Mailing Address - State:CA
Mailing Address - Zip Code:95961-4227
Mailing Address - Country:US
Mailing Address - Phone:530-923-7900
Mailing Address - Fax:530-443-2124
Practice Address - Street 1:4979 OLIVEHURST AVE
Practice Address - Street 2:
Practice Address - City:OLIVEHURST
Practice Address - State:CA
Practice Address - Zip Code:95961-4227
Practice Address - Country:US
Practice Address - Phone:530-923-7900
Practice Address - Fax:530-443-2124
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-01
Last Update Date:2024-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy