NPIMap

Organization Active NPI

Medbank Pharmacy, LLC

  • Community/Retail Pharmacy
  • Hazelwood, MO
National Provider Identifier
1376009183
Registry record updated Feb 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
MEDBANK PHARMACY, LLC
Practice address
637 Dunn Rd Ste 100
Hazelwood, MO 63042-1755
Phone
(314) 662-7597
NPI assigned
Feb 17, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2019

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

Authorized official

Name
Haytham Mostafa, RPHNPI 1407520547
Title
Pharmacy Owner and Manager
Phone
(314) 662-7597

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

637 Dunn Rd Ste 100
Hazelwood, MO 63042-1755

Mailing address

1003 Century Oaks Dr Apt H
Manchester, MO 63088-1259
Phone (314) 662-7597

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1550361600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1550361600000",
    "number": "1376009183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1003 CENTURY OAKS DR APT H",
            "city": "MANCHESTER",
            "state": "MO",
            "postal_code": "630881259",
            "telephone_number": "314-662-7597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "637 DUNN RD STE 100",
            "city": "HAZELWOOD",
            "state": "MO",
            "postal_code": "630421755",
            "telephone_number": "314-662-7597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDBANK PHARMACY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-17",
        "last_updated": "2019-02-17",
        "status": "A",
        "authorized_official_last_name": "MOSTAFA",
        "authorized_official_first_name": "HAYTHAM",
        "authorized_official_title_or_position": "PHARMACY OWNER AND MANAGER",
        "authorized_official_telephone_number": "314-662-7597",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hazelwood, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2019; 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.