NPIMap

Organization Active NPI

Montgomery County Memorial Hospital

Doing business as MCMH Pharmacy

  • Community/Retail Pharmacy
  • Red Oak, IA
National Provider Identifier
1104602549
Registry record updated Sep 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
MONTGOMERY COUNTY MEMORIAL HOSPITAL
Doing business as
MCMH Pharmacy
Practice address
600 Senate Ave
Red Oak, IA 51566-1283
Phone
(712) 623-1900
NPI assigned
Sep 1, 2023
Last updated
Sep 6, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
MONTGOMERY COUNTY MEMORIAL HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 6, 2023

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

Authorized official

Name
Bryant J Blay
Title
Cfo
Phone
(712) 623-7000

Specialties & licenses 2

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

Addresses

Primary practice location

600 Senate Ave
Red Oak, IA 51566-1283

Mailing address

PO Box 498
Red Oak, IA 51566-0498
Phone (712) 623-7000

Other names 1

  • MCMH Pharmacy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Montogomery Co Mem Hosp11 organizations share this tax ID, including this one
Part of
Montogomery Co Mem Hosp

Other organizations with this tax ID 10

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

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/2204183e-6c83-4c63-94c0-94d8c17a6ef8/

Practitioners & affiliated clinicians

Practitioners 6

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": "1693526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693958400000",
    "number": "1104602549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 498",
            "city": "RED OAK",
            "state": "IA",
            "postal_code": "515660498",
            "telephone_number": "712-623-7000",
            "fax_number": "712-623-7224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 SENATE AVE",
            "city": "RED OAK",
            "state": "IA",
            "postal_code": "515661283",
            "telephone_number": "712-623-1900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONTGOMERY COUNTY MEMORIAL HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MONTGOMERY COUNTY MEMORIAL HOSPITAL",
        "enumeration_date": "2023-09-01",
        "last_updated": "2023-09-06",
        "certification_date": "2023-09-06",
        "status": "A",
        "authorized_official_last_name": "BLAY",
        "authorized_official_first_name": "BRYANT",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "712-623-7000"
    },
    "taxonomies": [
        {
            "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": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MCMH Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MCMH Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Red Oak, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2023; 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.