Merle Pharmacy No. 1, Inc.

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

054002430 Issued in IL

Legal business name

MERLE PHARMACY NO. 1, INC.

Practice address

203 E Locust St
Suite 1
Bloomington, IL 61701-3077

Phone

(309) 828-2242

Fax

(309) 827-4638

NPI assigned

Mar 22, 2006

Organization subpart

No

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

Authorized official

Name

Mr. William M. Martin, R.PH.NPI 1912957093

Title

President

Phone

(309) 828-2242

Specialties & licenses 3

Addresses

Other identifiers 3

Locations

Practitioners 1

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

• William M Martin, R.PH.

  • Pharmacist
  • Bloomington, IL
  • NPI 1912957093
  NPD Authorized official

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

{
    "created_epoch": "1142985600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719878400000",
    "number": "1407815061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 E LOCUST ST",
            "address_2": "SUITE 1",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617013077",
            "telephone_number": "309-828-2242",
            "fax_number": "309-827-4638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 E LOCUST ST",
            "address_2": "SUITE 1",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617013077",
            "telephone_number": "309-828-2242",
            "fax_number": "309-827-4638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERLE PHARMACY NO. 1, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-22",
        "last_updated": "2024-07-02",
        "certification_date": "2024-07-02",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "309-828-2242",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "R.PH."
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "IL",
            "license": "054002430",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "IL",
            "license": "054002430",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "IL",
            "license": "054002430",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NABP NUMBER",
            "identifier": "1430925",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE PHARMACY LICENSE",
            "identifier": "054002430",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONTROL DRUG LICENSE NO.",
            "identifier": "032000672",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Community/Retail Pharmacy in Bloomington, IL
• Providers in Bloomington, IL by specialty
• Community/Retail Pharmacy in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2024; 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.