Town & Country Super Market Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

2005015586 Issued in MO

Legal business name

TOWN & COUNTRY SUPER MARKET INC

Doing business as

Country Mart Pharmacy #2416

Practice address

508 E 5TH St
Dixon, MO 65459-6201

Phone

(573) 759-3073

Fax

(573) 759-3560

NPI assigned

Nov 8, 2005

Last updated

Dec 4, 2012By the provider in NPPES

Organization subpart

Yes

Parent organization

TOWN & COUNTRY SUPER MARKET INCAs reported in NPPES

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

Authorized official

Name

Mrs. Janet Gott, RPHNPI 1265785489

Title

Pharmacy Supervisor

Phone

(573) 729-4091

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Country Mart Pharmacy #2416 Doing business as

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Other NPIs on the same Medicare enrollment 3

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

• Town & Country Super Market Inc

  dba Country Mart Pharmacy #2425

  • Community/Retail Pharmacy
  • Steelville, MO
  • NPI 1952382913

  O20130325000304

  Same enrollment
• Town and Country Super Market , Inc

  dba d/b/a Hixson Drug

  • Pharmacist
  • Ozark, MO
  • NPI 1427524594

  O20130325000304

  Same enrollment
• Town and Country Super Market Inc

  dba Town & Country Pharmacy #688

  • Community/Retail Pharmacy
  • Piedmont, MO
  • NPI 1457844748

  O20130325000304

  Same enrollment

Part of

Town Country Super Market

Locations

Practitioners 2

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.

• Janet L Gott, RPH

  • Pharmacist
  • Salem, MO
  • NPI 1265785489
  Authorized official Same address or phone
• Mary Kaye Hall, R.PH.

  • Pharmacist
  • Dixon, MO
  • NPI 1639869761
  NPD (past)

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

{
    "created_epoch": "1131408000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1354579200000",
    "number": "1083695902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 748",
            "city": "SALEM",
            "state": "MO",
            "postal_code": "655600748",
            "telephone_number": "573-729-4091",
            "fax_number": "573-729-2394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "508 E 5TH ST",
            "city": "DIXON",
            "state": "MO",
            "postal_code": "654596201",
            "telephone_number": "573-759-3073",
            "fax_number": "573-759-3560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOWN & COUNTRY SUPER MARKET INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TOWN & COUNTRY SUPER MARKET INC",
        "enumeration_date": "2005-11-08",
        "last_updated": "2012-12-04",
        "status": "A",
        "authorized_official_last_name": "GOTT",
        "authorized_official_first_name": "JANET",
        "authorized_official_title_or_position": "PHARMACY SUPERVISOR",
        "authorized_official_telephone_number": "573-729-4091",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "MO",
            "license": "2005015586",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MO",
            "license": "2005015586",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "626197701",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "606197705",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Country Mart Pharmacy #2416",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Denise Lorenz, LPC
• Carlene S McMillian, F.N.P.
• Romar Gianan Milos
• N & R of Dixon, LLC (Dixon Nursing & Rehab)
• Jessica Stewart, PT
• Charlene Pope Windsor, RN

• Community/Retail Pharmacy in Dixon, MO
• Providers in Dixon, 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 4, 2012; 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.