Medistat RX, LLC

Primary specialty

Compounding PharmacyTaxonomy code 3336C0004X

License

113031 Issued in AL

Legal business name

MEDISTAT RX, LLC

Practice address

110 E Azalea Ave
Foley, AL 36535-2540

Phone

(251) 923-2525

Fax

(866) 310-2803

NPI assigned

Jan 3, 2008

Organization subpart

No

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

Authorized official

Name

Mark Acker

Title

Ceo

Phone

(855) 737-2550

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• MediStat RX Doing business as

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• David Weston Clark, PHARM.D.

  • Pharmacist
  • Foley, AL
  • NPI 1912337700
  NPD (past)
• Steven Gifford, RPH

  • Pharmacist
  • Fairhope, AL
  • NPI 1891123642
  NPD (past)
• Elizabeth Catlin Staton, PHARM.D.

  • Pharmacist
  • Foley, AL
  • NPI 1952722936
  NPD (past)
• Vivian Elaine Waller

  • Pharmacist
  • Daphne, AL
  • NPI 1073943031
  NPD (past)

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

{
    "created_epoch": "1199318400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1418947200000",
    "number": "1366627770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 E AZALEA AVE",
            "city": "FOLEY",
            "state": "AL",
            "postal_code": "365352540",
            "telephone_number": "855-737-2550",
            "fax_number": "866-310-2803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 E AZALEA AVE",
            "city": "FOLEY",
            "state": "AL",
            "postal_code": "365352540",
            "telephone_number": "251-923-2525",
            "fax_number": "866-310-2803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDISTAT RX, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-03",
        "last_updated": "2014-12-19",
        "status": "A",
        "authorized_official_last_name": "ACKER",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "855-737-2550"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "AL",
            "license": "113031",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "1996235",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MediStat RX",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Laura Ashley Meador, D.M.D
• Michael Meador Jr., D.M.D
• Med-South, Inc.
• Med-South, Inc.
• Med-Trans Corporation
• Medstar Emergency Medical Service, LLC
• Menm, LLC
• William Paul Mentzer Jr., MSPT
• Katharina Meyer, MD
• Jennifer Koch Mezick, PA-C

• All providers in Foley, AL
• Compounding Pharmacy in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 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.