Madison Avenue Pharmacy Inc

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

Legal business name

MADISON AVENUE PHARMACY INC

Practice address

640 N Fountain Ave
Springfield, OH 45504-2202

Phone

(937) 323-1841

Fax

(937) 323-1016

NPI assigned

Sep 29, 2023

Organization subpart

No

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

Authorized official

Name

Eric Timothy Juergens

Title

President

Phone

(937) 323-1841

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1695945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695945600000",
    "number": "1487434205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "640 N FOUNTAIN AVE",
            "city": "SPRINGFIELD",
            "state": "OH",
            "postal_code": "455042202",
            "telephone_number": "937-323-1841",
            "fax_number": "937-323-1016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 N FOUNTAIN AVE",
            "city": "SPRINGFIELD",
            "state": "OH",
            "postal_code": "455042202",
            "telephone_number": "937-323-1841",
            "fax_number": "937-323-1016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MADISON AVENUE PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-29",
        "last_updated": "2023-09-29",
        "certification_date": "2023-09-28",
        "status": "A",
        "authorized_official_last_name": "JUERGENS",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "TIMOTHY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "937-323-1841"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathalene Maddy
• Farzaneh Mader
• Joseph Patrick Mader, AA
• Madison Avenue Pharmacy
• Madison Avenue Pharmacy Inc
• Jeffrey William Maendel
• Jayde Magee
• Mitchell J Maginnis, OD
• Mark Thomas Main, PT
• Jenna Mains

• Long Term Care Pharmacy in Springfield, OH
• Providers in Springfield, OH by specialty
• Long Term Care Pharmacy in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2023; 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.