Madison Avenue Pharmacy

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

LPED110 Issued in OH

Legal business name

MADISON AVENUE PHARMACY

Practice address

640 N Fountain Ave
Springfield, OH 45504-2202

Phone

(937) 323-1841

Fax

(937) 323-1016

NPI assigned

Feb 20, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Ginger Lynnette Hennig, L.PED.

Title

Pedorthist

Phone

(937) 788-2402

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218585600000",
    "number": "1295879369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "640 N FOUNTAIN AVE",
            "city": "SPRINGFIELD",
            "state": "OH",
            "postal_code": "455042202",
            "telephone_number": "937-323-1841",
            "fax_number": "937-323-1016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 N FOUNTAIN AVE",
            "city": "SPRINGFIELD",
            "state": "OH",
            "postal_code": "455042202",
            "telephone_number": "937-323-1841",
            "fax_number": "937-323-1016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MADISON AVENUE PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-20",
        "last_updated": "2008-08-13",
        "status": "A",
        "authorized_official_last_name": "HENNIG",
        "authorized_official_first_name": "GINGER",
        "authorized_official_middle_name": "LYNNETTE",
        "authorized_official_title_or_position": "PEDORTHIST",
        "authorized_official_telephone_number": "937-788-2402",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "L.PED."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "OH",
            "license": "LPED110",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0970883",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shari Lynn Macswain, R.PH.
• Mad River Township
• Kathalene Maddy
• Farzaneh Mader
• Joseph Patrick Mader, AA
• Madison Avenue Pharmacy Inc
• Madison Avenue Pharmacy Inc
• Jeffrey William Maendel
• Jayde Magee
• Mitchell J Maginnis, OD

• Durable Medical Equipment & Medical Supplies in Springfield, OH
• Providers in Springfield, OH by specialty
• Durable Medical Equipment & Medical Supplies in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2008; 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.