Provider Demographics
NPI:1912721754
Name:MACE'S PHARMACY, INC.
Entity type:Organization
Organization Name:MACE'S PHARMACY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RALPH
Authorized Official - Middle Name:RICHARD
Authorized Official - Last Name:MACE
Authorized Official - Suffix:III
Authorized Official - Credentials:RPH
Authorized Official - Phone:304-457-4233
Mailing Address - Street 1:440 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:PHILIPPI
Mailing Address - State:WV
Mailing Address - Zip Code:26416-0015
Mailing Address - Country:US
Mailing Address - Phone:304-457-4233
Mailing Address - Fax:304-457-6760
Practice Address - Street 1:440 S MAIN ST
Practice Address - Street 2:
Practice Address - City:PHILIPPI
Practice Address - State:WV
Practice Address - Zip Code:26416-0015
Practice Address - Country:US
Practice Address - Phone:304-457-4233
Practice Address - Fax:304-457-6760
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-08
Last Update Date:2024-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy