Matt's RX,LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

004747 Issued in MO

Legal business name

MATT'S RX,LLC

Doing business as

Matt's Medicine Store

Practice address

11200 1-2 E US Highway 24
Independence, MO 64054-1514

Phone

(816) 833-3636

Fax

(816) 833-1071

NPI assigned

Jun 4, 2006

Last updated

Dec 8, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Charles Matthew Mallinson

Title

Member

Phone

(816) 833-3636

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Matt's Medicine Store Doing business as

Locations

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

{
    "created_epoch": "1149379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1260230400000",
    "number": "1073551495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11200 1-2 E US HIGHWAY 24",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640541514",
            "telephone_number": "816-833-3636",
            "fax_number": "816-833-1071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11200 1-2 E US HIGHWAY 24",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640541514",
            "telephone_number": "816-833-3636",
            "fax_number": "816-833-1071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MATT'S RX,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-04",
        "last_updated": "2009-12-08",
        "status": "A",
        "authorized_official_last_name": "MALLINSON",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "MATTHEW",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "816-833-3636"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MO",
            "license": "004747",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "602442402",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "622442408",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Matt's Medicine Store",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• James B Marx, DO
• Shelby Massey, DO
• Sierra Mathews
• Thomas Mathews, D.O.
• Monica R Mathis, OPENING ADULT DAY
• Samantha Mattheis, CPNP
• John A Mattoni Jr., M.D.
• Rhonda Catherine Mattson, MOTR/L, CHT
• Aaliyah Maurice
• Stephanie Warren Mayer, NP

• Community/Retail Pharmacy in Independence, MO
• Providers in Independence, MO by specialty
• Community/Retail Pharmacy in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2009; 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.