Provider Demographics
NPI:1316483258
Name:MAILMYPRESCRIPTIONS COM PHARMACY CORPORATION
Entity type:Organization
Organization Name:MAILMYPRESCRIPTIONS COM PHARMACY CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:RANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:PARKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-964-9654
Mailing Address - Street 1:951 CLINT MOORE RD
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33487-2804
Mailing Address - Country:US
Mailing Address - Phone:800-964-9654
Mailing Address - Fax:844-862-6121
Practice Address - Street 1:951 CLINT MOORE RD
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33487-2804
Practice Address - Country:US
Practice Address - Phone:800-964-9654
Practice Address - Fax:844-862-6121
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-17
Last Update Date:2022-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3336C0003X, 3336M0002X
FLPH305193336M0002X, 3336M0002X
AZY0073503336M0002X
MDP076883336M0002X
MN2653383336M0002X
IN64002438A3336M0002X
IA48933336M0002X
DCNRX17012153336M0002X
MO20180018263336M0002X
ID46709MS3336M0002X
KYFL23273336M0002X
KS22-1044163336M0002X
AK1196723336M0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336M0002XSuppliersPharmacyMail Order Pharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2167036OtherPK