Active NPI
Medley Pharmacy Inc
Doing business as LTC Medley Pharmacy
- Long Term Care Pharmacy
- Owensville, MO
National Provider Identifier
1346717097
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Long Term Care Pharmacy
- Legal business name
- MEDLEY PHARMACY INC
- Doing business as
- LTC Medley Pharmacy
- Practice address
- 601 E. Highway 28
Owensville, MO 65066 - Phone
- (573) 437-3440
- NPI assigned
- Oct 31, 2018
- Last updated
- Sep 12, 2022
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Local Health Missouri Inc
- Title
- Owner
- Phone
- (573) 885-0885
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Long Term Care Pharmacy | 3336L0003X | Primary |
Addresses
Primary practice location
601 E. Highway 28
Owensville, MO 65066
Mailing address
PO Box 528
Cuba, MO 65453-0528
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 601586209 | Medicaid | MO |
Other names 1
- LTC Medley Pharmacy
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 26D2006720 | Medley Pharmacy | Certificate of waiver | Apr 27, 2028 |
National Provider Directory
National Provider Directory- Tax ID family
- Sinks Pharmacy 100
Other organizations with this tax ID 40
Organizations that report the same tax identification number in the National Provider Directory.
-
- Durable Medical Equipment & Medical Supplies
- Owensville, MO
- NPI 1053431726
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1540944000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1662940800000",
"number": "1346717097",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 528",
"city": "CUBA",
"state": "MO",
"postal_code": "654530528"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "601 E. HIGHWAY 28",
"city": "OWENSVILLE",
"state": "MO",
"postal_code": "65066",
"telephone_number": "573-437-3440"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MEDLEY PHARMACY INC",
"organizational_subpart": "NO",
"enumeration_date": "2018-10-31",
"last_updated": "2022-09-12",
"certification_date": "2022-09-12",
"status": "A",
"authorized_official_last_name": "MISSOURI INC",
"authorized_official_first_name": "LOCAL HEALTH",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "573-885-0885"
},
"taxonomies": [
{
"code": "3336L0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Long Term Care Pharmacy",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "601586209",
"state": "MO"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "LTC Medley Pharmacy",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "LTC Medley Pharmacy",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Owensville, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.