MK Infusion Pharmacy LLC

Primary specialty

Home Infusion Therapy PharmacyTaxonomy code 3336H0001X

License

114617 Issued in AL

Legal business name

MK INFUSION PHARMACY LLC

Doing business as

MK Infusion Pharmacy, LLC.

Practice address

307 W State St
Muscle Shoals, AL 35661-2835

Phone

(256) 320-7611

Fax

(256) 320-7607

NPI assigned

Apr 11, 2016

Organization subpart

No

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

Authorized official

Name

Missy Montgomery, PHARM.D.

Title

Clinical Pharmacist / Ceo

Phone

(256) 320-7611

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• MK Infusion Pharmacy, LLC. Doing business as

Medicare fee-for-service enrollment

Enrolled in AL2 enrollments

Enrollment records 2

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Melissa Keeton Montgomery, PHARM.D.

  • Pharmacist
  • Memphis, TN
  • NPI 1053547422
  NPD

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

{
    "created_epoch": "1460332800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607990400000",
    "number": "1093179509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 W STATE ST",
            "city": "MUSCLE SHOALS",
            "state": "AL",
            "postal_code": "356612835",
            "telephone_number": "256-320-7611",
            "fax_number": "256-320-7607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 W STATE ST",
            "city": "MUSCLE SHOALS",
            "state": "AL",
            "postal_code": "356612835",
            "telephone_number": "256-320-7611",
            "fax_number": "256-320-7607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MK INFUSION PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-11",
        "last_updated": "2020-12-15",
        "certification_date": "2020-12-15",
        "status": "A",
        "authorized_official_last_name": "MONTGOMERY",
        "authorized_official_first_name": "MISSY",
        "authorized_official_title_or_position": "CLINICAL PHARMACIST / CEO",
        "authorized_official_telephone_number": "256-320-7611",
        "authorized_official_credential": "PHARM.D."
    },
    "taxonomies": [
        {
            "code": "332BP3500X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
            "state": "MS",
            "license": "14795/7.1",
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "TN",
            "license": "0000005791",
            "primary": false
        },
        {
            "code": "3336H0001X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Home Infusion Therapy Pharmacy",
            "state": "AL",
            "license": "114617",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "187872",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2159515",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MK Infusion Pharmacy, LLC.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Julia G. Mills, CRNA
• Milner Rushing, Inc (Milner Rushing Drugs)
• Bridget Leanne Minnick, SLP
• Martina Renee Mitchell, CRNP
• David Mittwede, DPT
• Montgomery Keeton Infusion Center, LLC.
• Kinsey Payne Montgomery, FNP-BC
• Bobby J Moore, D.M.D.
• Kimberly Moore, OTR/L
• Lindsey Moore, CRNP

• Home Infusion Therapy Pharmacy in Muscle Shoals, AL
• Providers in Muscle Shoals, AL by specialty
• Home Infusion Therapy Pharmacy in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2020; 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.