NPIMap

Organization Active NPI

Marshfield Clinic Pharmacy, LLC

  • Pharmacy
  • Marshfield, MO
National Provider Identifier
1154621803
Registry record updated Oct 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
2004036065 Issued in MO
Legal business name
MARSHFIELD CLINIC PHARMACY, LLC
Practice address
483 Pomme de Terre
Marshfield, MO 65706-2386
Phone
(417) 468-4442
Fax
(417) 468-4462
NPI assigned
Oct 28, 2010
Last updated
Oct 28, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2010

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

Authorized official

Name
Mr. Michael Anthony Vinehout, RPHNPI 1164576997
Title
Owner/Pharmacist-in-Charge
Phone
(417) 468-4442

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X 2004036065 MO Primary

Addresses

Primary practice location

483 Pomme de Terre
Marshfield, MO 65706-2386

Mailing address

483 Pomme de Terre
Marshfield, MO 65706-2386
Phone (417) 468-4442

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101206001196 MO Part B Supplier - Mass Immunization (Roster Biller Only) 7214147792 Practice locations: Marshfield, MO

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Marshfield Clinic Pharmacy LLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

483 Pomme de Terre
#483
Marshfield, MO 65706

Practitioners & affiliated clinicians

Practitioners 1

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": "1288224000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288224000000",
    "number": "1154621803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "483 POMME DE TERRE",
            "city": "MARSHFIELD",
            "state": "MO",
            "postal_code": "657062386",
            "telephone_number": "417-468-4442",
            "fax_number": "417-468-4462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "483 POMME DE TERRE",
            "city": "MARSHFIELD",
            "state": "MO",
            "postal_code": "657062386",
            "telephone_number": "417-468-4442",
            "fax_number": "417-468-4462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARSHFIELD CLINIC PHARMACY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-28",
        "last_updated": "2010-10-28",
        "status": "A",
        "authorized_official_last_name": "VINEHOUT",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "OWNER/PHARMACIST-IN-CHARGE",
        "authorized_official_telephone_number": "417-468-4442",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "MO",
            "license": "2004036065",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marshfield, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.