Organization Active NPI

Rinne Pharmacy LLC

Doing business as Rinne Pharmacy

  • Community/Retail Pharmacy
  • Licking, MO
National Provider Identifier
1689062770
Registry record updated Apr 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
2014043698 Issued in MO
Legal business name
RINNE PHARMACY LLC
Doing business as
Rinne Pharmacy
Practice address
100 Deer Lick St
Licking, MO 65542-9081
Phone
(573) 674-2995
Fax
(573) 674-3001
NPI assigned
Dec 26, 2014
Last updated
Apr 19, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2016

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

Authorized official

Name
Jeremy Rinne, PHARMDNPI 1568055846
Title
Owner/Pic
Phone
(417) 350-4619

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X NU
Community/Retail Pharmacy 3336C0003X 2014043698 MO Primary
Long Term Care Pharmacy 3336L0003X NU

Addresses

Primary practice location

100 Deer Lick St
Licking, MO 65542-9081

Mailing address

PO Box 495
Licking, MO 65542-0495
Phone (573) 674-2995

Other identifiers 2

IdentifierTypeStateIssuer
600019101MedicaidMO
2148776OtherPK

Other names 1

  • Rinne Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20170809000359 MO Part B Supplier - Mass Immunization (Roster Biller Only) 7416228432 Practice locations: Licking, MO
O20170921002997 MO DME Supplier - Pharmacy 7416228432 Practice locations: Licking, MO

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Rinne Pharmacy100 Deer Lick St, Licking, MO 65542-9081(573) 674-2995 Immunosuppressive Drugs|Nebulizer Drugs|Oral Antiemetic Drugs|Blood Glucose Monitors/Supplies (Non-Mail Order)|Blood Glucose Monitors/Supplies (Mail Order)|Canes and/or Crutches|Ostomy Supplies|Urological Supplies|Surgical Dressings Accepts assignmentParticipating since Jun 30, 2016

National Provider Directory

National Provider Directory

Locations

100 Deer Lick St
Licking, MO 65542
Phone (573) 674-2995

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1419552000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1461024000000",
    "number": "1689062770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 495",
            "city": "LICKING",
            "state": "MO",
            "postal_code": "655420495",
            "telephone_number": "573-674-2995",
            "fax_number": "573-674-3001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 DEER LICK ST",
            "city": "LICKING",
            "state": "MO",
            "postal_code": "655429081",
            "telephone_number": "573-674-2995",
            "fax_number": "573-674-3001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RINNE PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-26",
        "last_updated": "2016-04-19",
        "status": "A",
        "authorized_official_last_name": "RINNE",
        "authorized_official_first_name": "JEREMY",
        "authorized_official_title_or_position": "OWNER/PIC",
        "authorized_official_telephone_number": "417-350-4619",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MO",
            "license": "2014043698",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "600019101",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2148776",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rinne Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Licking, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.