Medicate Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

9272-42 Issued in WI

Legal business name

MEDICATE PHARMACY INC

Practice address

2741 W Layton Ave Ste 102
Milwaukee, WI 53221-2600

Phone

(414) 539-3912

Fax

(414) 539-3913

NPI assigned

Jul 7, 2014

Organization subpart

No

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

Authorized official

Name

Vibha Surani

Title

President

Phone

(630) 624-3545

Specialties & licenses 4

Addresses

Other identifiers 2

Other names 1

• Medicate Pharmacy Inc Doing business as

Locations

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

{
    "created_epoch": "1404691200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1480377600000",
    "number": "1558777938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2741 W LAYTON AVE STE 102",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532212600",
            "telephone_number": "414-539-3912",
            "fax_number": "414-539-3913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2741 W LAYTON AVE STE 102",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532212600",
            "telephone_number": "414-539-3912",
            "fax_number": "414-539-3913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICATE PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-07",
        "last_updated": "2016-11-29",
        "status": "A",
        "authorized_official_last_name": "SURANI",
        "authorized_official_first_name": "VIBHA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "630-624-3545"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "WI",
            "license": "9272-42",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100038961",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2146746",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Medicate Pharmacy Inc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Community/Retail Pharmacy in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2016; 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.