MDM Healthcare Inc

Primary specialty

PharmacistTaxonomy code 183500000X

License

054018756 Issued in IL

Legal business name

MDM HEALTHCARE INC

Doing business as

ofallon pharmacy medicine shoppe

Practice address

122 W State Street
Ofallon, IL 62269

Phone

(618) 632-8309

NPI assigned

Oct 22, 2014

Last updated

Oct 22, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Melissa Epps, RPH

Title

Secretary

Phone

(618) 632-8309

Specialties & licenses 1

Addresses

Other names 1

• ofallon pharmacy medicine shoppe Doing business as

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

{
    "created_epoch": "1413936000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1413936000000",
    "number": "1306241146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 W STATE STREET",
            "city": "OFALLON",
            "state": "IL",
            "postal_code": "62269",
            "telephone_number": "618-632-8309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 W STATE STREET",
            "city": "OFALLON",
            "state": "IL",
            "postal_code": "62269",
            "telephone_number": "618-632-8309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MDM HEALTHCARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-22",
        "last_updated": "2014-10-22",
        "status": "A",
        "authorized_official_last_name": "EPPS",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "618-632-8309",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "054018756",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ofallon pharmacy medicine shoppe",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Stefanie McLaughlin
• Angela Ailys McMillian, CRNA
• Bradley D McMillin
• Abigail E McPherson
• Michelle Denise McQuillan, DNP, FNP-BC
• Bailey Paige Meadows, BEHAVIOR TECHNICIAN
• Zachary Medema, M.S.
• Medexpress Urgent Care Illinois, PC (MedExpress Urgent Care - O'Fallon, W Highway 50)
• Stephen T Medford
• Nitika Dinesh Mehta, D.D.S.

• Pharmacist in O'Fallon, IL
• Providers in O'Fallon, IL by specialty
• Pharmacist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2014; 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.