NPIMap

Organization Active NPI

Sweet Springs Pharmacy Inc

Doing business as Marceline Family Pharmacy

  • Pharmacy
  • Marceline, MO
National Provider Identifier
1659616225
Registry record updated Nov 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
Legal business name
SWEET SPRINGS PHARMACY INC
Doing business as
Marceline Family Pharmacy
Practice address
1509 N Missouri Ave
Marceline, MO 64658
Phone
(660) 376-2700
NPI assigned
Dec 7, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2021

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

Authorized official

Name
Anthony Eugene Clark
Title
Director of Operations
Phone
(660) 247-1580

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X MO Primary

Addresses

Primary practice location

1509 N Missouri Ave
Marceline, MO 64658

Mailing address

PO Box 737
Chillicothe, MO 64601-0737
Phone (660) 707-0906

Other identifiers 1

IdentifierTypeStateIssuer
5576550001OtherMOMEDICARE PTAN

Other names 1

  • Marceline Family Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071217000821 MO Part B Supplier - Mass Immunization (Roster Biller Only) 0547350357 2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Cameron, MO; Marceline, MO; Sweet Springs, MO

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Sweet Springs Pharmacy Inc5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1509 N Missouri Ave
Marceline, MO 64658
Phone (660) 376-2700

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1354838400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1637625600000",
    "number": "1659616225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 737",
            "city": "CHILLICOTHE",
            "state": "MO",
            "postal_code": "646010737",
            "telephone_number": "660-707-0906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1509 N MISSOURI AVE",
            "city": "MARCELINE",
            "state": "MO",
            "postal_code": "64658",
            "telephone_number": "660-376-2700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SWEET SPRINGS PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-07",
        "last_updated": "2021-11-23",
        "certification_date": "2021-11-23",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_middle_name": "EUGENE",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "660-247-1580"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "MO",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "5576550001",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Marceline Family Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Marceline Family Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Marceline, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.