NPIMap

Organization Active NPI

Medley Pharmacy Inc

Doing business as Sinks Pharmacy

  • Community/Retail Pharmacy
  • Salem, MO
National Provider Identifier
1093706632
Registry record updated Sep 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
6425 Issued in MO
Legal business name
MEDLEY PHARMACY INC
Doing business as
Sinks Pharmacy
Practice address
1204 E Highway 32
Salem, MO 65560-2844
Phone
(573) 729-4091
Fax
(573) 729-2394
NPI assigned
Nov 2, 2005
Last updated
Sep 12, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
MEDLEY PHARMACY INCAs reported in NPPES

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 006425 MO
Durable Medical Equipment & Medical Supplies 332B00000X
Community/Retail Pharmacy 3336C0003X
Community/Retail Pharmacy 3336C0003X 6425 MO Primary

Addresses

Primary practice location

1204 E Highway 32
Salem, MO 65560-2844

Mailing address

PO Box 528
Cuba, MO 65453
Phone (573) 885-0885

Other identifiers 2

IdentifierTypeStateIssuer
603779703MedicaidMO
623779709MedicaidMO

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
O20210731000244 MO DME Supplier - Pharmacy 3577667682 Practice locations: Salem, 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
Part of
Sinks Pharmacy 100

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": "1130889600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1662940800000",
    "number": "1093706632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 528",
            "city": "CUBA",
            "state": "MO",
            "postal_code": "65453",
            "telephone_number": "573-885-0885",
            "fax_number": "573-885-0882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1204 E HIGHWAY 32",
            "city": "SALEM",
            "state": "MO",
            "postal_code": "655602844",
            "telephone_number": "573-729-4091",
            "fax_number": "573-729-2394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDLEY PHARMACY INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MEDLEY PHARMACY INC",
        "enumeration_date": "2005-11-02",
        "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": "006425",
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MO",
            "license": "6425",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "603779703",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "623779709",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sinks Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Salem, 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.