NPIMap

Organization Active NPI

Madison Apothecary Inc.

  • Community/Retail Pharmacy
  • Madison, IN
National Provider Identifier
1043381825
Registry record updated Sep 25, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
60006043A Issued in IN
Legal business name
MADISON APOTHECARY INC.
Practice address
835 W Main St
Madison, IN 47250-3131
Phone
(812) 265-4621
Fax
(812) 273-6666
NPI assigned
Nov 13, 2006
Last updated
Sep 25, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2007

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

Authorized official

Name
Dr. Erik R Grove, PHARM.D.NPI 1558402073
Title
President
Phone
(812) 265-4621

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 60006043A IN
Oxygen Equipment & Supplies (DME) 332BX2000X 60006043A IN
Community/Retail Pharmacy 3336C0003X IN1246 KY
Community/Retail Pharmacy 3336C0003X 60006043A IN Primary

Addresses

Primary practice location

835 W Main St
Madison, IN 47250-3131

Mailing address

835 W Main St
Madison, IN 47250-3131
Phone (812) 265-4621

Other identifiers 1

IdentifierTypeStateIssuer
200847540AMedicaidIN

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190678400000",
    "number": "1043381825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "835 W MAIN ST",
            "city": "MADISON",
            "state": "IN",
            "postal_code": "472503131",
            "telephone_number": "812-265-4621",
            "fax_number": "812-273-6666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "835 W MAIN ST",
            "city": "MADISON",
            "state": "IN",
            "postal_code": "472503131",
            "telephone_number": "812-265-4621",
            "fax_number": "812-273-6666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MADISON APOTHECARY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-13",
        "last_updated": "2007-09-25",
        "status": "A",
        "authorized_official_last_name": "GROVE",
        "authorized_official_first_name": "ERIK",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "812-265-4621",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARM.D."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "IN",
            "license": "60006043A",
            "primary": false
        },
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": "IN",
            "license": "60006043A",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "KY",
            "license": "IN1246",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "IN",
            "license": "60006043A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200847540A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.