Organization Active NPI

MRX Enterprises, Inc.

Doing business as Knisley Pharmacy

  • Community/Retail Pharmacy
  • Chillicothe, OH
National Provider Identifier
1679763346
Registry record updated Apr 29, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
021712250 Issued in OH
Legal business name
MRX ENTERPRISES, INC.
Doing business as
Knisley Pharmacy
Practice address
2535 Western Ave
Chillicothe, OH 45601
Phone
(740) 779-6226
Fax
(740) 779-6228
NPI assigned
Jul 30, 2007
Last updated
Apr 29, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2009

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

Authorized official

Name
Matthew Ryan Knisley, PHARMD
Title
President
Phone
(740) 779-6226

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 021712250 OH Primary

Addresses

Primary practice location

2535 Western Ave
Chillicothe, OH 45601

Mailing address

PO Box 898
2535 Western Avenue
Chillicothe, OH 45601-0898
Phone (740) 779-6226

Other identifiers 1

IdentifierTypeStateIssuer
2767144MedicaidOH

Other names 1

  • KNISLEY PHARMACY Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160216001722 OH Part B Supplier - Mass Immunization (Roster Biller Only) 1951495472 Practice locations: Chillicothe, OH

National Provider Directory

National Provider Directory

Locations

2535 Western Ave
Chillicothe, OH 45601
Phone (740) 779-6226

NPI Registry JSON

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

{
    "created_epoch": "1185753600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1240963200000",
    "number": "1679763346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 898",
            "address_2": "2535 WESTERN AVENUE",
            "city": "CHILLICOTHE",
            "state": "OH",
            "postal_code": "456010898",
            "telephone_number": "740-779-6226",
            "fax_number": "740-779-6228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2535 WESTERN AVE",
            "city": "CHILLICOTHE",
            "state": "OH",
            "postal_code": "45601",
            "telephone_number": "740-779-6226",
            "fax_number": "740-779-6228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MRX ENTERPRISES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-30",
        "last_updated": "2009-04-29",
        "status": "A",
        "authorized_official_last_name": "KNISLEY",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "RYAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "740-779-6226",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "OH",
            "license": "021712250",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2767144",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "KNISLEY PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chillicothe, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2009; 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.