Mayo Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

70 Issued in ND

Legal business name

MAYO PHARMACY INC

Practice address

303 North 4TH Street
Bismarck, ND 58501-4020

Phone

(701) 223-2424

Fax

(701) 258-2849

NPI assigned

Sep 26, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Kevin F Martian, PHARM.D.NPI 1457646374

Title

Pharmacist Owner

Phone

(701) 223-2424

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in ND2 enrollments

Enrollment records 2

Tax ID family

Mayo Pharmacy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Mayo Pharmacy Inc

  • Long Term Care Pharmacy
  • Bismarck, ND
  • NPI 1386275121
  NPD tax ID

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kevin F Martian, PHARM.D.

  • Pharmacist
  • Bismarck, ND
  • NPI 1457646374
  NPD Authorized official
• Bryon Lee Herbel, M.D.

  • Psychiatry Physician
  • Bismarck, ND
  • NPI 1154669844
  NPD (past)
• Daniel L Mayo, RPH

  • Pharmacist
  • Bismarck, ND
  • NPI 1306947296
  NPD (past)
• Paula Nagel

  • Pharmacist
  • Bismarck, ND
  • NPI 1689169534
  NPD (past)
• Tamara Ruggles, PHARMD

  • Pharmacist
  • Bismarck, ND
  • NPI 1033425384
  NPD (past)
• Kimberly Wilson, PHARM D

  • Pharmacist
  • Bismarck, ND
  • NPI 1174668545
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621468800000",
    "number": "1013018910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 NORTH 4TH STREET",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585014020",
            "telephone_number": "701-223-2424",
            "fax_number": "701-258-2849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 NORTH 4TH STREET",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585014020",
            "telephone_number": "701-223-2424",
            "fax_number": "701-258-2849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAYO PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-26",
        "last_updated": "2021-05-20",
        "certification_date": "2021-05-20",
        "status": "A",
        "authorized_official_last_name": "MARTIAN",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "PHARMACIST OWNER",
        "authorized_official_telephone_number": "701-223-2424",
        "authorized_official_credential": "PHARM.D."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "ND",
            "license": "70",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "ND",
            "license": "PHAR70",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NABP NCPDP",
            "identifier": "3500281",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1454036",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hattie Mauch
• James Maurer
• Maximized Chiropractic
• Brooklynn E Maxon-Pacheco, LBSW, LAC
• Abre May, PT
• Mayo Pharmacy Inc
• Daniel L Mayo, RPH
• Justin J McCabe, DCEP
• Shawn McCabe
• Michelle Ann McCamy, SW

• Community/Retail Pharmacy in Bismarck, ND
• Providers in Bismarck, ND by specialty
• Community/Retail Pharmacy in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.