Active NPI
Tim Mitchell Medical, Inc
- Long Term Care Pharmacy
- Neosho, MO
National Provider Identifier
1437650835
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Long Term Care Pharmacy
- License
- 2003027740
- Legal business name
- TIM MITCHELL MEDICAL, INC
- Doing business as
- Mitchell's Long Term Care Pharmacy
- Practice address
- 719 S Neosho Blvd Ste a
Neosho, MO 64850-2051 - Phone
- (417) 451-9501
- Fax
- (417) 451-9594
- NPI assigned
- Feb 22, 2018
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Timothy G Mitchell, RPH.
- Title
- Owner/Manager
- Phone
- (417) 451-9501
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Long Term Care Pharmacy | 3336L0003X | 2003027740 | MO | Primary |
Addresses
Primary practice location
719 S Neosho Blvd Ste a
Neosho, MO 64850-2051
Mailing address
719 S Neosho Blvd Ste D
Neosho, MO 64850-2051
Phone (417) 455-1883
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 602932303 | Medicaid | MO |
Other names 1
- Mitchell's Long Term Care Pharmacy
National Provider Directory
National Provider Directory- Tax ID family
- Pineville Pharmacy
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Long Term Care Pharmacy
- Neosho, MO
- NPI 1477230845
Locations
719 S Neosho Blvd
Ste A
Neosho, MO 64850
Phone (417) 451-9501
719 S Neosho Blvd
Ste D
Neosho, MO 64850
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1519257600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1746057600000",
"number": "1437650835",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "719 S NEOSHO BLVD STE D",
"city": "NEOSHO",
"state": "MO",
"postal_code": "648502051",
"telephone_number": "417-455-1883",
"fax_number": "417-455-2781"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "719 S NEOSHO BLVD STE A",
"city": "NEOSHO",
"state": "MO",
"postal_code": "648502051",
"telephone_number": "417-451-9501",
"fax_number": "417-451-9594"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "TIM MITCHELL MEDICAL, INC",
"organizational_subpart": "NO",
"enumeration_date": "2018-02-22",
"last_updated": "2025-05-01",
"certification_date": "2025-05-01",
"status": "A",
"authorized_official_last_name": "MITCHELL",
"authorized_official_first_name": "TIMOTHY",
"authorized_official_middle_name": "G",
"authorized_official_title_or_position": "OWNER/MANAGER",
"authorized_official_telephone_number": "417-451-9501",
"authorized_official_credential": "RPH."
},
"taxonomies": [
{
"code": "3336L0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Long Term Care Pharmacy",
"state": "MO",
"license": "2003027740",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "602932303",
"state": "MO"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Mitchell's Long Term Care Pharmacy",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Neosho, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.