Provider Demographics
NPI:1346022175
Name:MAO PHARMACY, INC.
Entity type:Organization
Organization Name:MAO PHARMACY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE-PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:OLEY
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:804-288-1933
Mailing Address - Street 1:5823 PATTERSON AVE
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23226-2536
Mailing Address - Country:US
Mailing Address - Phone:804-288-1933
Mailing Address - Fax:
Practice Address - Street 1:21641 RIDGETOP CIR STE 109
Practice Address - Street 2:
Practice Address - City:STERLING
Practice Address - State:VA
Practice Address - Zip Code:20166-6597
Practice Address - Country:US
Practice Address - Phone:703-651-8827
Practice Address - Fax:703-574-4907
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MAO PHARMACY, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-10-17
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy