Marketime Drug of Moscow Inc

Primary specialty

PharmacyTaxonomy code 333600000X

License

217CP Issued in ID

Legal business name

MARKETIME DRUG OF MOSCOW INC

Doing business as

Marketime Drug

Practice address

872 Troy Rd Ste 120
Moscow, ID 83843-5037

Phone

(208) 882-7541

Fax

(208) 883-4716

NPI assigned

Aug 24, 2006

Last updated

Jan 4, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Erik James Nelson, PHARMDNPI 1215377544

Title

President

Phone

(509) 455-9345

Specialties & licenses 3

Addresses

Other identifiers 3

Other names 1

• Marketime Drug Doing business as

Locations

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.

• Erik James Nelson, PHARMD

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Spokane, WA
  • NPI 1215377544
  NPD (past) Authorized official

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

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1609718400000",
    "number": "1750498044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "872 TROY RD STE 120",
            "city": "MOSCOW",
            "state": "ID",
            "postal_code": "838435037",
            "telephone_number": "208-882-7541",
            "fax_number": "208-883-4716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "872 TROY RD STE 120",
            "city": "MOSCOW",
            "state": "ID",
            "postal_code": "838435037",
            "telephone_number": "208-882-7541",
            "fax_number": "208-883-4716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARKETIME DRUG OF MOSCOW INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-24",
        "last_updated": "2021-01-04",
        "certification_date": "2021-01-04",
        "status": "A",
        "authorized_official_last_name": "NELSON",
        "authorized_official_first_name": "ERIK",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "509-455-9345",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "ID",
            "license": "217CP",
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0023395",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID DME",
            "identifier": "0023396",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID",
            "identifier": "6021422",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Marketime Drug",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Marketime Drug",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Candace Louise Magnuson, LMT
• Diego Maldonado Quezada
• Sophia Tsai Malmquist, LPC
• Patricia N. Marciano, M.D.
• Marketime Drug of Moscow Inc
• Teodora Rose Marquez
• Christopher David Marshall, BA
• Christian Edith Martinez
• Nickolai Martonick
• Kurt R Martyn, MD

• Pharmacy in Moscow, ID
• Providers in Moscow, ID by specialty
• Pharmacy in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2021; 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.