Food Merchants LLC
Organization Active NPI Specialty Pharmacy · Nixa, MO
NPI 1356891774 · NPPES record last updated Apr 3, 2024
Key facts
- NPI
- 1356891774
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Specialty Pharmacy 3336S0011X
- License
- 2016042467 (MO)
- Legal business name
- FOOD MERCHANTS LLC
- Practice address
- 105 S Ridgecrest Ave Ste 3a
Nixa, MO 65714-6206 - Phone
- (417) 719-4510
- Fax
- (417) 893-3908
- NPI assigned
- Oct 10, 2016
- Organization subpart
- No
Authorized official
- Name
- Donald G Savley
- Title
- Owner
- Phone
- (417) 818-3125
Other NPIs on the same Medicare enrollment 3
Other NPIs with the same Medicare PAC ID 1
Member of 1
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 26D2127426 | Alps Specialty Pharmacy | Certificate of waiver | Mar 13, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in MO
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20170210000521 | MO | Part B Supplier - Pharmacy | 1456569029 |
3 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Springfield, MO; Nixa, MO; Anderson, MO |
| O20220103000060 | MO | DME Supplier - Pharmacy | 1456569029 | Practice locations: Nixa, MO |
National Provider Directory
Locations
1824 N State Highway CC
Ste B
Nixa, MO 65714
Phone (417) 719-4510
2650 W Kearney St
Ste 116
Springfield, MO 65803
Phone (417) 210-7003
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Infusion Agency | 251F00000X | |||
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | |||
| Compounding Pharmacy | 3336C0004X | |||
| Long Term Care Pharmacy | 3336L0003X | |||
| Specialty Pharmacy | 3336S0011X | 2016042467 | MO | Yes |
Addresses
Primary practice location
105 S Ridgecrest Ave Ste 3a
Nixa, MO 65714-6206
Mailing address
PO Box 397
Nixa, MO 65714-0397
Phone (417) 818-3125
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2165739 | Other | PK | |
| 600039189 | Medicaid | MO |
Other names
- Alps Specialty Pharmacy
Other providers in Nixa, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 3, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.