Mack'S Grocery, LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

2004007107 Issued in MO

Legal business name

MACK'S GROCERY, LLC

Practice address

1047 S Maguire St
Warrensburg, MO 64093-2618

Phone

(660) 747-7449

Fax

(660) 747-5037

NPI assigned

Jul 15, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Luke A Hagle, RPH

Title

Pharmacist in Charge

Phone

(660) 747-7449

Specialties & licenses 1

Addresses

Other names 1

• Parkers Pharmacy Doing business as

Tax ID family

Mack'S Grocery LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Macks Grocery Inc

  • Community/Retail Pharmacy
  • Warrensburg, MO
  • NPI 1740298132
  NPD tax ID

Locations

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

{
    "created_epoch": "1152921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202083200000",
    "number": "1093731408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1117",
            "city": "WARRENSBURG",
            "state": "MO",
            "postal_code": "640937117",
            "telephone_number": "660-747-7449",
            "fax_number": "660-747-5037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1047 S MAGUIRE ST",
            "city": "WARRENSBURG",
            "state": "MO",
            "postal_code": "640932618",
            "telephone_number": "660-747-7449",
            "fax_number": "660-747-5037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MACK'S GROCERY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-15",
        "last_updated": "2008-02-04",
        "status": "A",
        "authorized_official_last_name": "HAGLE",
        "authorized_official_first_name": "LUKE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PHARMACIST IN CHARGE",
        "authorized_official_telephone_number": "660-747-7449",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MO",
            "license": "2004007107",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Parkers Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Victor Manuel Lovell, MD
• Alexa Jean Luking
• Shelly M Lynch, NP
• Cheryl Ann Lyon, WHNP-C
• Brandon Machicao
• Macks Grocery Inc
• Neha Mahajan
• Melissa Joann Mahoney
• Nathan Manning
• Virginia Nicole Manuel, OD

• Community/Retail Pharmacy in Warrensburg, MO
• Providers in Warrensburg, 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 Feb 4, 2008; 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.