Extended Pharmacy 2 LLC

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

Legal business name

EXTENDED PHARMACY 2 LLC

Practice address

6030 W 62ND St
Indianapolis, IN 46278-2909

Phone

(317) 343-2056

Fax

(877) 361-5651

NPI assigned

Oct 24, 2018

Organization subpart

No

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

Authorized official

Name

Adam McCoy, PHARM. D.NPI 1548860802

Title

Owner

Phone

(317) 343-2056

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Adam McCoy, PHARM. D.

  • Pharmacist
  • Indianapolis, IN
  • NPI 1548860802
  NPD Authorized official

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

{
    "created_epoch": "1540339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695859200000",
    "number": "1780151191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6030 W 62ND ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462782909",
            "telephone_number": "317-343-2056",
            "fax_number": "877-361-5651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6030 W 62ND ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462782909",
            "telephone_number": "317-343-2056",
            "fax_number": "877-361-5651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXTENDED PHARMACY 2 LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-24",
        "last_updated": "2023-09-28",
        "certification_date": "2023-09-28",
        "status": "A",
        "authorized_official_last_name": "MCCOY",
        "authorized_official_first_name": "ADAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "317-343-2056",
        "authorized_official_credential": "PHARM. D."
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.