MC5 Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

6604042 Issued in WI

Legal business name

MC5 INC

Practice address

1173 W Main St
Whitewater, WI 53190-1672

Phone

(262) 473-5065

Fax

(262) 473-7357

NPI assigned

Aug 29, 2006

Organization subpart

No

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

Authorized official

Name

James McCullough

Title

Vice President

Phone

(262) 248-8582

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• MCCULLOUGHS PRESCRIPTION AND GIFTS Doing business as

Locations

Practitioners 1

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

• Grant McCullough, PHARMD, RPH

  • Pharmacist
  • Whitewater, WI
  • NPI 1619570975
  NPD

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1481241600000",
    "number": "1093824880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "694 S WELLS ST",
            "city": "LAKE GENEVA",
            "state": "WI",
            "postal_code": "531472106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1173 W MAIN ST",
            "city": "WHITEWATER",
            "state": "WI",
            "postal_code": "531901672",
            "telephone_number": "262-473-5065",
            "fax_number": "262-473-7357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MC5 INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-29",
        "last_updated": "2016-12-09",
        "status": "A",
        "authorized_official_last_name": "MCCULLOUGH",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "262-248-8582"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "WI",
            "license": "6604042",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33048100",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER",
            "identifier": "5115844",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MCCULLOUGHS PRESCRIPTION AND GIFTS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Anna Lynne Maas, M.S. CCC-SLP
• Courtney Martens, RN
• Sharon Jo Martin, LMT
• Kathryn Mattingly
• MC 5 Inc
• Julie McCalip, LCSW
• Grant McCullough, PHARMD, RPH
• Robert McCullough, RPH
• Courtney Jane McGee, PHARMD
• Geraldine Louise McGrorty Buchholz I, REGISTERED NURSE

• Community/Retail Pharmacy in Whitewater, WI
• Providers in Whitewater, WI by specialty
• Community/Retail Pharmacy in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2016; 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.