Teaco, Inc

Primary specialty

PharmacistTaxonomy code 183500000X

License

2004011813 Issued in MO

Legal business name

TEACO, INC

Doing business as

Teko Pharmacy

Practice address

501 Teaco Rd
Kennett, MO 63857-3721

Phone

(573) 888-6673

NPI assigned

Aug 19, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Jerid E Maddox, PHARM.D.

Title

Pic

Phone

(573) 888-6673

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Teko Pharmacy Doing business as

Locations

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1414627200000",
    "number": "1356455778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 TEACO RD",
            "city": "KENNETT",
            "state": "MO",
            "postal_code": "638573721",
            "telephone_number": "573-888-6673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 TEACO RD",
            "city": "KENNETT",
            "state": "MO",
            "postal_code": "638573721",
            "telephone_number": "573-888-6673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TEACO, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-19",
        "last_updated": "2014-10-30",
        "status": "A",
        "authorized_official_last_name": "MADDOX",
        "authorized_official_first_name": "JERID",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PIC",
        "authorized_official_telephone_number": "573-888-6673",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PHARM.D."
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pharmacist",
            "state": "MO",
            "license": "2004011813",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "60095005",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "2617225",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE #",
            "identifier": "2004011813",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Teko Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Laura Tansil, LPN
• Sarah Elizabeth Tansil
• Heather Leeann Tarno
• Julie Nicole Tatum
• Teaco, Inc
• Ted W Duensing DO LTD
• Kelvin Terry
• Ashley Thacker
• The Counseling Center, L.L.C.
• The Dental Studio of Kennett

• Pharmacist in Kennett, MO
• Providers in Kennett, MO by specialty
• Pharmacist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 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.