NPIMap

Organization Active NPI

Medley Pharmacy

  • Long Term Care Pharmacy
  • Rolla, MO
National Provider Identifier
1144798679
Registry record updated Sep 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
Legal business name
MEDLEY PHARMACY
Practice address
1375 E 10TH St Ste B
Rolla, MO 65401-3591
Phone
(573) 364-9616
NPI assigned
Nov 2, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2022

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

Authorized official

Name
Local Health Missouri Inc
Title
Owner
Phone
(573) 885-0885

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Long Term Care Pharmacy 3336L0003X Primary

Addresses

Primary practice location

1375 E 10TH St Ste B
Rolla, MO 65401-3591

Mailing address

PO Box 528
Cuba, MO 65453-0528

Other identifiers 1

IdentifierTypeStateIssuer
623143005MedicaidMO

Other names 1

  • LTC Sinks Pharmacy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Sinks Pharmacy41 organizations share this tax ID, including this one

Other organizations with this tax ID 40

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

View all 40

Locations

1375 E 10th St
Ste B
Rolla, MO 65401
Phone (573) 364-9616

NPI Registry JSON

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

{
    "created_epoch": "1541116800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1662940800000",
    "number": "1144798679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 528",
            "city": "CUBA",
            "state": "MO",
            "postal_code": "654530528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1375 E 10TH ST STE B",
            "city": "ROLLA",
            "state": "MO",
            "postal_code": "654013591",
            "telephone_number": "573-364-9616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDLEY PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-02",
        "last_updated": "2022-09-12",
        "certification_date": "2022-09-12",
        "status": "A",
        "authorized_official_last_name": "MISSOURI INC",
        "authorized_official_first_name": "LOCAL HEALTH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "573-885-0885"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "623143005",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LTC Sinks Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "LTC Sinks Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rolla, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2022; 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.