NPIMap

Organization Active NPI

Medley Pharmacy Inc

Doing business as LTC Evercare Pharmacy

  • Long Term Care Pharmacy
  • Trenton, MO
National Provider Identifier
1780407015
Registry record updated Nov 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
Legal business name
MEDLEY PHARMACY INC
Doing business as
LTC Evercare Pharmacy
Practice address
1903 E 9TH St
Trenton, MO 64683-2645
Phone
(660) 359-5700
Fax
(660) 359-5701
NPI assigned
Nov 5, 2024
Last updated
Nov 5, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
MEDLEY PHARMACY INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 5, 2024

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

Authorized official

Name
Jillian Garrison, CPHT
Title
Licensing/Credentialing Specialist
Phone
(573) 885-0885

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Long Term Care Pharmacy 3336L0003X Primary

Addresses

Primary practice location

1903 E 9TH St
Trenton, MO 64683-2645

Mailing address

PO Box 528
Cuba, MO 65453-0528
Phone (573) 885-0885

Other names 1

  • LTC EVERCARE PHARMACY Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Sinks Pharmacy 10041 organizations share this tax ID, including this one
Part of
Sinks Pharmacy 100

Other organizations with this tax ID 40

Organizations that report the same tax identification number in the National Provider Directory.

View all 40

NPI Registry JSON

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

{
    "created_epoch": "1730764800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730764800000",
    "number": "1780407015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 528",
            "city": "CUBA",
            "state": "MO",
            "postal_code": "654530528",
            "telephone_number": "573-885-0885",
            "fax_number": "573-677-0567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1903 E 9TH ST",
            "city": "TRENTON",
            "state": "MO",
            "postal_code": "646832645",
            "telephone_number": "660-359-5700",
            "fax_number": "660-359-5701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDLEY PHARMACY INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MEDLEY PHARMACY INC",
        "enumeration_date": "2024-11-05",
        "last_updated": "2024-11-05",
        "certification_date": "2024-11-05",
        "status": "A",
        "authorized_official_last_name": "GARRISON",
        "authorized_official_first_name": "JILLIAN",
        "authorized_official_title_or_position": "LICENSING/CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "573-885-0885",
        "authorized_official_credential": "CPHT"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LTC EVERCARE PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Trenton, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2024; 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.