NPIMap

Organization Active NPI

Mayo Pharmacy Inc

Doing business as Mayo Pharmacy (LTC)

  • Long Term Care Pharmacy
  • Bismarck, ND
National Provider Identifier
1386275121
Registry record updated Jun 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
Legal business name
MAYO PHARMACY INC
Doing business as
Mayo Pharmacy (LTC)
Practice address
303 N 4TH St
Bismarck, ND 58501-4020
Phone
(701) 223-2424
Fax
(701) 258-2849
NPI assigned
Jan 30, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2020

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

Authorized official

Name
Kevin F MartianNPI 1457646374
Title
Owner
Phone
(701) 223-2424

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
Long Term Care Pharmacy 3336L0003X Primary

Addresses

Primary practice location

303 N 4TH St
Bismarck, ND 58501-4020

Mailing address

303 N 4TH St
Bismarck, ND 58501-4020
Phone (701) 223-2424

Other identifiers 1

IdentifierTypeStateIssuer
1454036MedicaidND

Other names 1

  • Mayo Pharmacy (LTC) Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Mayo Pharmacy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

303 N 4th St
Bismarck, ND 58501
Phone (701) 223-2424

Practitioners & affiliated clinicians

Practitioners 6

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": "1580342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1592438400000",
    "number": "1386275121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 N 4TH ST",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585014020",
            "telephone_number": "701-223-2424",
            "fax_number": "701-258-2849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 N 4TH ST",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585014020",
            "telephone_number": "701-223-2424",
            "fax_number": "701-258-2849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAYO PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-30",
        "last_updated": "2020-06-18",
        "certification_date": "2020-06-18",
        "status": "A",
        "authorized_official_last_name": "MARTIAN",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "701-223-2424"
    },
    "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": "1454036",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mayo Pharmacy (LTC)",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bismarck, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2020; 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.