NPIMap

Organization Active NPI

Medley Pharmacy Inc.

Doing business as Sinks Pharmacy

  • Community/Retail Pharmacy
  • Iberia, MO
National Provider Identifier
1093058034
Registry record updated Sep 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
MEDLEY PHARMACY INC.
Doing business as
Sinks Pharmacy
Practice address
2322 Hwy 17
Iberia, MO 65486-0000
Phone
(573) 793-2050
Fax
(573) 793-2075
NPI assigned
Mar 28, 2013
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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X MO
Community/Retail Pharmacy 3336C0003X MO Primary

Addresses

Primary practice location

2322 Hwy 17
Iberia, MO 65486-0000

Mailing address

PO Box 528
Owensville, MO 65066-0528
Phone (573) 437-3440

Other identifiers 1

IdentifierTypeStateIssuer
600005037MedicaidMO

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
O20130812000379 MO DME Supplier - Pharmacy 3577667682 Practice locations: Iberia, 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

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
26D2071759Sinks Pharmacy2322 Hwy 17, Iberia, MO 65486Certificate of waiverJan 16, 2028

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

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": "1364428800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1662940800000",
    "number": "1093058034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 528",
            "city": "OWENSVILLE",
            "state": "MO",
            "postal_code": "650660528",
            "telephone_number": "573-437-3440",
            "fax_number": "573-437-6909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2322 HWY 17",
            "city": "IBERIA",
            "state": "MO",
            "postal_code": "654860000",
            "telephone_number": "573-793-2050",
            "fax_number": "573-793-2075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDLEY PHARMACY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-28",
        "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": "MO",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MO",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "600005037",
            "state": "MO"
        }
    ],
    "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 Iberia, 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.
  • 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.