CM Specialty Pharmacy LLC

Primary specialty

Compounding PharmacyTaxonomy code 3336C0004X

License

60006341A Issued in IN

Legal business name

CM SPECIALTY PHARMACY LLC

Practice address

5510 Lafayette Rd Ste 260
Indianapolis, IN 46254-1691

Phone

(317) 803-2069

Fax

(317) 293-1836

NPI assigned

Sep 9, 2013

Organization subpart

No

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

Authorized official

Name

Jeff Jackson

Title

Owner/Pharmacist

Phone

(317) 803-2069

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• CM Specialty Pharmacy Doing business as

Locations

Practitioners 1

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

• Jeffrey W Jackson, R.PH.

  • Pharmacist
  • Indianapolis, IN
  • NPI 1952421927
  NPD (past)

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

{
    "created_epoch": "1378684800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1470355200000",
    "number": "1609201730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6005 W 71ST ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462781705",
            "telephone_number": "317-803-3436",
            "fax_number": "317-803-3437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5510 LAFAYETTE RD STE 260",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462541691",
            "telephone_number": "317-803-2069",
            "fax_number": "317-293-1836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CM SPECIALTY PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-09",
        "last_updated": "2016-08-05",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "JEFF",
        "authorized_official_title_or_position": "OWNER/PHARMACIST",
        "authorized_official_telephone_number": "317-803-2069"
    },
    "taxonomies": [
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "IN",
            "license": "60006341A",
            "primary": true
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2141973",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CM Specialty Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Juanita Clowers, NP
• Ryan Adam Cloyd, MD/PHD
• Robert E Clutter, MD
• Linda Jane Clutz, LMHC
• Kristin Jean Clyne, ANP, PMHNP-BC
• Anna Margaret Cmolik, MA
• CMT Heart Mobility & Transport LLC
• CMW Medical LLC
• Coach Dreammakers L.L.C.
• Coach Dreammakers LLC

• Compounding Pharmacy in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Compounding Pharmacy in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 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.