NPIMap

Organization Active NPI

Med-Mart Pharmacy LLC

  • Community/Retail Pharmacy
  • London, KY
National Provider Identifier
1740501543
Registry record updated Jan 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
P07400 Issued in KY
Legal business name
MED-MART PHARMACY LLC
Practice address
87 C V B Dr
London, KY 40741-1096
Phone
(606) 878-1200
Fax
(606) 878-1214
NPI assigned
Jun 15, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2011

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

Authorized official

Name
Michael Sizemore
Title
President
Phone
(606) 878-1200

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X P07400 KY Primary
Compounding Pharmacy 3336C0004X

Addresses

Primary practice location

87 C V B Dr
London, KY 40741-1096

Mailing address

87 CVB Dr
London, KY 40741
Phone (606) 878-1200

Other identifiers 2

IdentifierTypeStateIssuer
1831913OtherNCPDP PROVIDER IDENTIFICATION NUMBER
7100120850MedicaidKY

Other names 1

  • MED-MART PHARMACY Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1276560000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1294617600000",
    "number": "1740501543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "87 CVB DR",
            "city": "LONDON",
            "state": "KY",
            "postal_code": "40741",
            "telephone_number": "606-878-1200",
            "fax_number": "606-878-1214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "87 C V B DR",
            "city": "LONDON",
            "state": "KY",
            "postal_code": "407411096",
            "telephone_number": "606-878-1200",
            "fax_number": "606-878-1214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MED-MART PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-15",
        "last_updated": "2011-01-10",
        "status": "A",
        "authorized_official_last_name": "SIZEMORE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "606-878-1200"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "KY",
            "license": "P07400",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "1831913",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100120850",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MED-MART PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in London, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2011; 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.