Organization Active NPI

McQuades Marketplace Pharmacy

Doing business as McQuades Pharmacy Inc

  • Community/Retail Pharmacy
  • Mystic, CT
National Provider Identifier
1770687964
Registry record updated Aug 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
1547 Issued in CT
Legal business name
MCQUADES MARKETPLACE PHARMACY
Doing business as
McQuades Marketplace Pharmacy
McQuades Pharmacy Inc
Practice address
10 Clara Dr
Mystic, CT 06355-1957
Phone
(860) 536-4606
Fax
(860) 536-9629
NPI assigned
Sep 11, 2006
Last updated
Aug 6, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2026

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

Authorized official

Name
Courtney McQuadeNPI 1225499916
Title
Owner/RPH
Phone
(860) 536-4606

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 1547 CT Primary
Long Term Care Pharmacy 3336L0003X

Addresses

Primary practice location

10 Clara Dr
Mystic, CT 06355-1957

Mailing address

10 Clara Dr
Mystic, CT 06355-1957
Phone (860) 536-4606

Other identifiers 2

IdentifierTypeStateIssuer
004140836MedicaidCT
2001485OtherPK

Other names 2

  • MCQUADES MARKETPLACE PHARMACY Doing business as
  • MCQUADES PHARMACY INC Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180515002160 CT Part B Supplier - Mass Immunization (Roster Biller Only) 4385764315 Practice locations: Mystic, CT

National Provider Directory

National Provider Directory

Locations

10 Clara Dr
Mystic, CT 06355
Phone (860) 536-4606

Practitioners & affiliated clinicians

Practitioners 2

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": "1157932800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1785974400000",
    "number": "1770687964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 CLARA DR",
            "city": "MYSTIC",
            "state": "CT",
            "postal_code": "063551957",
            "telephone_number": "860-536-4606",
            "fax_number": "860-536-9629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 CLARA DR",
            "city": "MYSTIC",
            "state": "CT",
            "postal_code": "063551957",
            "telephone_number": "860-536-4606",
            "fax_number": "860-536-9629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCQUADES MARKETPLACE PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-11",
        "last_updated": "2026-08-06",
        "certification_date": "2026-08-06",
        "status": "A",
        "authorized_official_last_name": "MCQUADE",
        "authorized_official_first_name": "COURTNEY",
        "authorized_official_title_or_position": "OWNER/RPH",
        "authorized_official_telephone_number": "860-536-4606"
    },
    "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": "CT",
            "license": "1547",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004140836",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2001485",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MCQUADES MARKETPLACE PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MCQUADES PHARMACY INC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MCQUADES PHARMACY INC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mystic, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.