Active NPI
Charles A Mulik, RP.H
- Pharmacist
- Neosho, MO
National Provider Identifier
1710182233
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 026895
- Practice address
- 1000 S Neosho Blvd
Neosho, MO 64850-2007 - Phone
- (417) 451-9501
- Fax
- (417) 451-9594
- NPI assigned
- Jun 15, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 026895 | MO | Primary |
Addresses
Primary practice location
1000 S Neosho Blvd
Neosho, MO 64850-2007
Mailing address
1120 Peterson Rd
Neosho, MO 64850-2921
Phone (417) 451-2892
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 026895 | MO | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tim Mitchell Medical, Inc. | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Durable Medical Equipment & Medical Supplies
- Neosho, MO
- NPI 1952440422
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1181865600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1710182233",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1120 PETERSON RD",
"city": "NEOSHO",
"state": "MO",
"postal_code": "648502921",
"telephone_number": "417-451-2892"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 S NEOSHO BLVD",
"city": "NEOSHO",
"state": "MO",
"postal_code": "648502007",
"telephone_number": "417-451-9501",
"fax_number": "417-451-9594"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MULIK",
"first_name": "CHARLES",
"middle_name": "A",
"name_prefix": "Mr.",
"credential": "RP.H",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-06-15",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MO",
"license": "026895",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Neosho, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.