NPIMap

Organization Active NPI

Putnam County Memorial Hospital

Doing business as Putnam County Memorial Hospital Pharmacy

  • Community/Retail Pharmacy
  • Unionville, MO
National Provider Identifier
1750763322
Registry record updated Nov 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
2015019365 Issued in MO
Legal business name
PUTNAM COUNTY MEMORIAL HOSPITAL
Doing business as
Putnam County Memorial Hospital Pharmacy
Practice address
1926 Oak St
Unionville, MO 63565-1180
Phone
(660) 947-2574
Fax
(660) 947-2576
NPI assigned
Jun 19, 2015
Reactivated
Nov 18, 2019
Last updated
Nov 18, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2019

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

Authorized official

Name
Mariah Hollabaugh
Title
Director of Pharmacy
Phone
(660) 947-3673

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 2015019365 MO Primary
Long Term Care Pharmacy 3336L0003X NU

Addresses

Primary practice location

1926 Oak St
Unionville, MO 63565-1180

Mailing address

1926 Oak St
Unionville, MO 63565-1180
Phone (660) 947-2574

Other identifiers 1

IdentifierTypeStateIssuer
2152660OtherPK

Other names 1

  • Putnam County Memorial Hospital Pharmacy Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 10

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": "1434672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1574035200000",
    "number": "1750763322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1926 OAK ST",
            "city": "UNIONVILLE",
            "state": "MO",
            "postal_code": "635651180",
            "telephone_number": "660-947-2574",
            "fax_number": "660-947-2576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1926 OAK ST",
            "city": "UNIONVILLE",
            "state": "MO",
            "postal_code": "635651180",
            "telephone_number": "660-947-2574",
            "fax_number": "660-947-2576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PUTNAM COUNTY MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-19",
        "last_updated": "2019-11-18",
        "deactivation_date": "2018-07-24",
        "reactivation_date": "2019-11-18",
        "status": "A",
        "authorized_official_last_name": "HOLLABAUGH",
        "authorized_official_first_name": "MARIAH",
        "authorized_official_title_or_position": "DIRECTOR OF PHARMACY",
        "authorized_official_telephone_number": "660-947-3673"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MO",
            "license": "2015019365",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2152660",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Putnam County Memorial Hospital Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Unionville, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2019; 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.