Marketime Drug of Moscow Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

MARKETIME DRUG OF MOSCOW INC

Practice address

872 Troy Rd Ste 120
Moscow, ID 83843-5037

Phone

(208) 882-7541

NPI assigned

Jan 5, 2021

Organization subpart

No

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

Authorized official

Name

Erik James NelsonNPI 1215377544

Title

Owner

Phone

(509) 868-6559

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Erik James Nelson, PHARMD

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Spokane, WA
  • NPI 1215377544
  NPD (past) Authorized official

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

{
    "created_epoch": "1609804800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1648771200000",
    "number": "1164010229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "872 TROY RD STE 120",
            "city": "MOSCOW",
            "state": "ID",
            "postal_code": "838435037",
            "telephone_number": "208-882-7541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "872 TROY RD STE 120",
            "city": "MOSCOW",
            "state": "ID",
            "postal_code": "838435037",
            "telephone_number": "208-882-7541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARKETIME DRUG OF MOSCOW INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-05",
        "last_updated": "2022-04-01",
        "certification_date": "2022-04-01",
        "status": "A",
        "authorized_official_last_name": "NELSON",
        "authorized_official_first_name": "ERIK",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "509-868-6559"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0023396",
            "state": "ID"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.marketimdrug.com",
            "affiliation": "N",
            "address_1": "872 Troy Rd Ste 120",
            "city": "Moscow",
            "state": "ID",
            "country_code": "US",
            "postal_code": "838435037",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Lori Marie Mages, PT, PCS
• Candace Louise Magnuson, LMT
• Diego Maldonado Quezada
• Sophia Tsai Malmquist, LPC
• Patricia N. Marciano, M.D.
• Marketime Drug of Moscow Inc
• Teodora Rose Marquez
• Christopher David Marshall, BA
• Christian Edith Martinez
• Nickolai Martonick

• Community/Retail Pharmacy in Moscow, ID
• Providers in Moscow, ID by specialty
• Community/Retail Pharmacy in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 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.