NPIMap

Organization Active NPI

Medley Pharmacy Inc.

  • Pharmacy
  • Chillicothe, MO
National Provider Identifier
1043324015
Registry record updated Jul 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
Legal business name
MEDLEY PHARMACY INC.
Practice address
601 Locust St
Chillicothe, MO 64601-2250
Phone
(660) 646-7455
Fax
(660) 646-4838
NPI assigned
Aug 18, 2006
Organization subpart
Yes
Parent organization
MEDLEY PHARMACY INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 25, 2023

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

Authorized official

Name
Mrs. Amy Mitchell
Title
President
Phone
(573) 885-0885

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Nursing Facility Supplies (DME) 332BN1400X
Pharmacy 333600000X Primary
Community/Retail Pharmacy 3336C0003X 2002007461 MO
Community/Retail Pharmacy 3336C0003X
Long Term Care Pharmacy 3336L0003X
Prosthetic/Orthotic Supplier 335E00000X

Addresses

Primary practice location

601 Locust St
Chillicothe, MO 64601-2250

Mailing address

330 N. Franklin
PO Box 528
Cuba, MO 65453
Phone (573) 885-0885

Other identifiers 2

IdentifierTypeStateIssuer
605679307MedicaidMO
2634435OtherNCPDP PROVIDER IDENTIFICATION NUMBER

Other names 1

  • Hometown Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20070329000503 MO Part B Supplier - Mass Immunization (Roster Biller Only) 3577667682 18 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Owensville, MO
O20220329001026 MO Part B Supplier - Pharmacy 2365500295 Practice locations: Chillicothe, MO
O20230914002097 MO DME Supplier - Pharmacy 3577667682 Practice locations: Chillicothe, MO

Other NPIs with the same Medicare PAC ID 19

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 19

Other NPIs on the same Medicare enrollment 18

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 18

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
26D1088254Hometown Pharmacy Chillicothe601 Locust, Chillicothe, MO 64601Certificate of waiverAug 19, 2026

National Provider Directory

National Provider Directory
Tax ID family
Hometown Pharmacy2 organizations share this tax ID, including this one
Part of
Sinks Pharmacy

Other organizations with this tax ID 1

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

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

601 Locust St
#1045
Chillicothe, MO 64601

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690243200000",
    "number": "1043324015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 N. FRANKLIN",
            "address_2": "PO BOX 528",
            "city": "CUBA",
            "state": "MO",
            "postal_code": "65453",
            "telephone_number": "573-885-0885",
            "fax_number": "573-677-0567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 LOCUST ST",
            "city": "CHILLICOTHE",
            "state": "MO",
            "postal_code": "646012250",
            "telephone_number": "660-646-7455",
            "fax_number": "660-646-4838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDLEY PHARMACY INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MEDLEY PHARMACY INC.",
        "enumeration_date": "2006-08-18",
        "last_updated": "2023-07-25",
        "certification_date": "2023-07-25",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "573-885-0885",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332BN1400X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Nursing Facility Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MO",
            "license": "2002007461",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "605679307",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "2634435",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hometown Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chillicothe, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.