Provider Demographics
NPI:1932385440
Name:MEI SERVICES INC
Entity Type:Organization
Organization Name:MEI SERVICES INC
Other - Org Name:PHARMALIFE BOSTON
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:BOGACHEU
Authorized Official - Suffix:
Authorized Official - Credentials:PHRMD
Authorized Official - Phone:404-933-3296
Mailing Address - Street 1:2915 PIEDMONT RD NE
Mailing Address - Street 2:STE A
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30305-2782
Mailing Address - Country:US
Mailing Address - Phone:404-261-7775
Mailing Address - Fax:404-261-4917
Practice Address - Street 1:367 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:BRIGHTON
Practice Address - State:MA
Practice Address - Zip Code:02135-2730
Practice Address - Country:US
Practice Address - Phone:617-787-4700
Practice Address - Fax:404-261-4917
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-14
Last Update Date:2013-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X
MA35693336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
2242206OtherNCPDP PROVIDER IDENTIFICATION NUMBER
MA000811137BMedicaid
2242206OtherNCPDP PROVIDER IDENTIFICATION NUMBER