Medipharm Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

20617 Issued in AR

Legal business name

MEDIPHARM INC

Practice address

125 W Polk Ave
West Memphis, AR 72301-4264

Phone

(870) 394-4209

Fax

(901) 382-9966

NPI assigned

Dec 14, 2009

Organization subpart

No

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

Authorized official

Name

Chiemezie Oti

Title

Pharmacy Director

Phone

(870) 394-4209

Specialties & licenses 5

Addresses

Other identifiers 1

Other names 1

• MediPharm Pharmacy Doing business as

Tax ID family

Medipharm Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• Medipharm Inc

  • Long Term Care Pharmacy
  • Memphis, TN
  • NPI 1780980631
  NPD tax ID
• Medipharm Inc.

  • Internal Medicine Physician
  • Memphis, TN
  • NPI 1033406111
  NPD tax ID

Locations

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

{
    "created_epoch": "1260748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1265760000000",
    "number": "1144559592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 W POLK AVE",
            "city": "WEST MEMPHIS",
            "state": "AR",
            "postal_code": "723014264",
            "telephone_number": "870-394-4209",
            "fax_number": "901-382-9966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 W POLK AVE",
            "city": "WEST MEMPHIS",
            "state": "AR",
            "postal_code": "723014264",
            "telephone_number": "870-394-4209",
            "fax_number": "901-382-9966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDIPHARM INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-14",
        "last_updated": "2010-02-10",
        "status": "A",
        "authorized_official_last_name": "OTI",
        "authorized_official_first_name": "CHIEMEZIE",
        "authorized_official_title_or_position": "PHARMACY DIRECTOR",
        "authorized_official_telephone_number": "870-394-4209"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "AR",
            "license": "20617",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336M0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Mail Order Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "0423311",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MediPharm Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Genesis Tiara McKinney
• Kimberly Jan McNeal, DMD
• Janet S McNeely
• Jasmine L McNeill
• Beunka Bra'Shawn McVay
• Mending Minds Counseling and Consultation, LLC
• Megan Meredith
• Jeanette Merritt
• Constance Mickens, PLMSW
• Mid South Health Care, PLLC

• Community/Retail Pharmacy in West Memphis, AR
• Providers in West Memphis, AR by specialty
• Community/Retail Pharmacy in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2010; 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.