Medicate Pharmacy Shoppes Inc

Primary specialty

PharmacyTaxonomy code 333600000X

License

BY4765472 Issued in IL

Legal business name

MEDICATE PHARMACY SHOPPES INC

Doing business as

Yociss Pharmacy

Practice address

7602 State St
East Saint Louis, IL 62203-1708

Phone

(618) 397-3331

Fax

(618) 397-6050

NPI assigned

Oct 14, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Lawrence L Wiseman Jr., PHARMACIST

Title

Owner Pharmacist

Phone

(618) 397-3331

Specialties & licenses 1

Addresses

Other names 1

• Yociss Pharmacy Doing business as

Locations

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

{
    "created_epoch": "1160784000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1598855926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7602 STATE ST",
            "city": "EAST SAINT LOUIS",
            "state": "IL",
            "postal_code": "622031708",
            "telephone_number": "618-397-3331",
            "fax_number": "618-397-6050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7602 STATE ST",
            "city": "EAST SAINT LOUIS",
            "state": "IL",
            "postal_code": "622031708",
            "telephone_number": "618-397-3331",
            "fax_number": "618-397-6050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICATE PHARMACY SHOPPES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WISEMAN",
        "authorized_official_first_name": "LAWRENCE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER PHARMACIST",
        "authorized_official_telephone_number": "618-397-3331",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "PHARMACIST"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "IL",
            "license": "BY4765472",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Yociss Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Pharmacy in East Saint Louis, IL
• Providers in East Saint Louis, IL by specialty
• Pharmacy in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.