Organization Active NPI

Metrolpolis Drugs II Inc

  • Community/Retail Pharmacy
  • Metropolis, IL
National Provider Identifier
1194866053
Registry record updated Dec 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
054.013117 Issued in IL
Legal business name
METROLPOLIS DRUGS II INC
Practice address
1201 W 10TH St
Metropolis, IL 62960-2433
Phone
(618) 524-8400
Fax
(618) 524-9961
NPI assigned
Feb 12, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2016

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

Authorized official

Name
Tim Lawson, RPH
Title
Owner/ Medicare Coordinator
Phone
(618) 524-8400

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 054.013117 IL Primary
Compounding Pharmacy 3336C0004X

Addresses

Primary practice location

1201 W 10TH St
Metropolis, IL 62960-2433

Mailing address

1201 W 10TH St
Metropolis, IL 62960-2433
Phone (618) 524-8400

Other identifiers 1

IdentifierTypeStateIssuer
2022209OtherPK

Other names 1

  • METROLPOLIS DRUGS II Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100930003272 IL DME Supplier - Pharmacy 5698896181 Practice locations: Metropolis, IL
O20161107001423 IL Part B Supplier - Mass Immunization (Roster Biller Only) 5698896181 Practice locations: Metropolis, IL

National Provider Directory

National Provider Directory
Tax ID family
Metropolis Drugs II Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1480896000000",
    "number": "1194866053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 W 10TH ST",
            "city": "METROPOLIS",
            "state": "IL",
            "postal_code": "629602433",
            "telephone_number": "618-524-8400",
            "fax_number": "618-524-9961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 W 10TH ST",
            "city": "METROPOLIS",
            "state": "IL",
            "postal_code": "629602433",
            "telephone_number": "618-524-8400",
            "fax_number": "618-524-9961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "METROLPOLIS DRUGS II INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-12",
        "last_updated": "2016-12-05",
        "status": "A",
        "authorized_official_last_name": "LAWSON",
        "authorized_official_first_name": "TIM",
        "authorized_official_title_or_position": "OWNER/ MEDICARE COORDINATOR",
        "authorized_official_telephone_number": "618-524-8400",
        "authorized_official_credential": "RPH"
    },
    "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": "IL",
            "license": "054.013117",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2022209",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "METROLPOLIS DRUGS II",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Metropolis, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2016; 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.