Mall Pharmacy, Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

054020079 Issued in IL

Legal business name

MALL PHARMACY, INC

Practice address

1815 S Meyers Rd Ste 100
Oakbrook Terrace, IL 60181-5226

Phone

(800) 592-7174

NPI assigned

Jan 1, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Matt R Cunningham

Title

President

Phone

(800) 592-7174

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Scripts Rx Pharmacy Doing business as

Locations

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

{
    "created_epoch": "1167609600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1638748800000",
    "number": "1104982230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1815 S MEYERS RD STE 100",
            "city": "OAKBROOK TERRACE",
            "state": "IL",
            "postal_code": "601815226",
            "telephone_number": "800-592-7174",
            "fax_number": "877-992-3831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1815 S MEYERS RD STE 100",
            "city": "OAKBROOK TERRACE",
            "state": "IL",
            "postal_code": "601815226",
            "telephone_number": "800-592-7174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MALL PHARMACY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-01",
        "last_updated": "2021-12-06",
        "certification_date": "2021-12-06",
        "status": "A",
        "authorized_official_last_name": "CUNNINGHAM",
        "authorized_official_first_name": "MATT",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "800-592-7174",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "IL",
            "license": "054020079",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "1468481",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Scripts Rx Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Scripts Rx Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Oakbrook Terrace, IL
• Providers in Oakbrook Terrace, IL by specialty
• Community/Retail Pharmacy in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2021; 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.