Active NPI
John Victor Tonjuk, RPH.
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- Marionville, MO
National Provider Identifier
1750622551
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- License
- 040215
- Practice address
- 201 S Highway 60
Marionville, MO 65705-9407 - Phone
- (417) 258-2526
- Fax
- (417) 463-2211
- NPI assigned
- Mar 5, 2013
- Last updated
- Mar 5, 2013
- 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 Clinician (PhC)/ Clinical Pharmacy Specialist | 1835P0018X | 040215 | MO | Primary |
Addresses
Primary practice location
201 S Highway 60
Marionville, MO 65705-9407
Mailing address
201 S Highway 60
P.O. Box 217
Marionville, MO 65705-9407
Phone (417) 258-2526
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 040215 | Other | MO | MISSOURI PHARMACIST LICENSE |
| 2629585 | Other | MO | NCPDP PROVIDER IDENTIFICATION NUMBER |
| 601199508 | Medicaid | MO |
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 |
|---|---|---|---|
| 040215 | MO | MD | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Marionville Pharmacy
- Durable Medical Equipment & Medical Supplies
- Marionville, MO
- NPI 1992786511
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1362441600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1362441600000",
"number": "1750622551",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "201 S HIGHWAY 60",
"address_2": "P.O. BOX 217",
"city": "MARIONVILLE",
"state": "MO",
"postal_code": "657059407",
"telephone_number": "417-258-2526",
"fax_number": "417-463-2211"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "201 S HIGHWAY 60",
"city": "MARIONVILLE",
"state": "MO",
"postal_code": "657059407",
"telephone_number": "417-258-2526",
"fax_number": "417-463-2211"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TONJUK",
"first_name": "JOHN",
"middle_name": "VICTOR",
"name_prefix": "Mr.",
"credential": "RPH.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-03-05",
"last_updated": "2013-03-05",
"status": "A"
},
"taxonomies": [
{
"code": "1835P0018X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
"state": "MO",
"license": "040215",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MISSOURI PHARMACIST LICENSE",
"identifier": "040215",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
"identifier": "2629585",
"state": "MO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "601199508",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Marionville, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.