MC 5 Inc

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

License

885142 Issued in WI

Legal business name

MC 5 INC

Practice address

1173 W Main St
Ste F
Whitewater, WI 53190-1672

Phone

(262) 473-5087

Fax

(262) 473-7357

NPI assigned

Jul 10, 2008

Organization subpart

No

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

Authorized official

Name

Robert McCullough

Title

President

Phone

(262) 473-5087

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• MCCULLOUGH'S LTC PHARMACY Doing business as

Medicare fee-for-service enrollment

Enrolled in WI2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Practitioners 1

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

• Grant McCullough, PHARMD, RPH

  • Pharmacist
  • Whitewater, WI
  • NPI 1619570975
  NPD

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

{
    "created_epoch": "1215648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1566345600000",
    "number": "1437313384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1173 W MAIN ST",
            "address_2": "STE F",
            "city": "WHITEWATER",
            "state": "WI",
            "postal_code": "531901672",
            "telephone_number": "262-473-5087",
            "fax_number": "262-473-7357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1173 W MAIN ST",
            "address_2": "STE F",
            "city": "WHITEWATER",
            "state": "WI",
            "postal_code": "531901672",
            "telephone_number": "262-473-5087",
            "fax_number": "262-473-7357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MC 5 INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-10",
        "last_updated": "2019-08-21",
        "status": "A",
        "authorized_official_last_name": "MCCULLOUGH",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "262-473-5087"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "WI",
            "license": "885142",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2116684",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MCCULLOUGH'S LTC PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MCCULLOUGH'S LTC PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Anna Marilyn Luterbach, OTR
• Anna Lynne Maas, M.S. CCC-SLP
• Courtney Martens, RN
• Sharon Jo Martin, LMT
• Kathryn Mattingly
• MC5 Inc
• Julie McCalip, LCSW
• Grant McCullough, PHARMD, RPH
• Robert McCullough, RPH
• Courtney Jane McGee, PHARMD

• Long Term Care Pharmacy in Whitewater, WI
• Providers in Whitewater, WI by specialty
• Long Term Care Pharmacy in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.