NPIMap

Organization Active NPI

Medley Pharmacy, Inc

Doing business as Sinks Pharmacy

  • Community/Retail Pharmacy
  • Waynesville, MO
National Provider Identifier
1043699499
Registry record updated Sep 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
2015014160 Issued in MO
Legal business name
MEDLEY PHARMACY, INC
Doing business as
Sinks Pharmacy
Practice address
1000 GW LN Ste 105
Waynesville, MO 65583-2339
Phone
(573) 433-2550
Fax
(573) 433-2552
NPI assigned
May 19, 2015
Last updated
Sep 12, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2022

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

Authorized official

Name
Local Health Missouri Inc
Title
Owner
Phone
(573) 885-0885

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X NU
Pharmacy 333600000X NU
Community/Retail Pharmacy 3336C0003X 2015014160 MO Primary
Long Term Care Pharmacy 3336L0003X NU

Addresses

Primary practice location

1000 GW LN Ste 105
Waynesville, MO 65583-2339

Mailing address

1000 GW LN
Suite 105
Waynesville, MO 65583-2339
Phone (573) 433-2550

Other identifiers 1

IdentifierTypeStateIssuer
2151976OtherPK

Other names 1

  • Sinks Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO2 enrollments

Enrollment records 2

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
O20160127002796 MO DME Supplier - Pharmacy 3577667682 Practice locations: Waynesville, MO

Other NPIs with the same Medicare PAC ID 18

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

View all 18

Other NPIs on the same Medicare enrollment 18

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

View all 18

National Provider Directory

National Provider Directory
Tax ID family
Sinks Pharmacy 10041 organizations share this tax ID, including this one

Other organizations with this tax ID 40

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

View all 40

NPI Registry JSON

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

{
    "created_epoch": "1431993600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1662940800000",
    "number": "1043699499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 GW LN",
            "address_2": "SUITE 105",
            "city": "WAYNESVILLE",
            "state": "MO",
            "postal_code": "655832339",
            "telephone_number": "573-433-2550",
            "fax_number": "573-433-2552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 GW LN STE 105",
            "city": "WAYNESVILLE",
            "state": "MO",
            "postal_code": "655832339",
            "telephone_number": "573-433-2550",
            "fax_number": "573-433-2552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDLEY PHARMACY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-19",
        "last_updated": "2022-09-12",
        "certification_date": "2022-09-12",
        "status": "A",
        "authorized_official_last_name": "MISSOURI INC",
        "authorized_official_first_name": "LOCAL HEALTH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "573-885-0885"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MO",
            "license": "2015014160",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2151976",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sinks Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Sinks Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Waynesville, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2022; 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.