Madison Medical Center
Organization Active NPI Long Term Care Pharmacy · Fredericktown, MO
NPI 1801948880 · NPPES record last updated Oct 10, 2016
Key facts
- NPI
- 1801948880
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Long Term Care Pharmacy 3336L0003X
- License
- 003980 (MO)
- Legal business name
- MADISON MEDICAL CENTER
- Practice address
- 611 W Main St
Fredericktown, MO 63645-1111 - Phone
- (573) 783-1047
- Fax
- (573) 783-1063
- NPI assigned
- Jan 18, 2007
- Organization subpart
- No
Authorized official
- Name
- Linda Hatch, RPH
- Title
- Pharmacy Director
- Phone
- (573) 783-1047
Corporate family (same tax ID) 8
National Provider Directory
- Tax ID family
- Madison Medical Center
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | |||
| Institutional Pharmacy | 3336I0012X | |||
| Long Term Care Pharmacy | 3336L0003X | 003980 | MO | Yes |
Addresses
Primary practice location
611 W Main St
Fredericktown, MO 63645-1111
Mailing address
611 W Main St
PO Box 431
Fredericktown, MO 63645-1111
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 601458003 | Medicaid | MO | |
| 010155109 | Medicaid | MO | |
| 2050238 | Other | PK |
Other names
- MADISON MEDICAL CENTER PHARMACY
Other providers in Fredericktown, MO
- Madison County Council for Developmentally Disabled, Inc.
- Madison County Health Department
- Madison County Service Coordination Inc
- Madison Medical Center
- Madison Medical Center
- Madison Medical Center Stockhoff Memorial Nursing Home
- Madison Medical Center Stockhoff Memorial Nursing Home
- Madison Medical Center Stockhoff Memorial Nursing Home
- Madison Medical Center Stockhoff Memorial Nursing Home
- Madison Medical Center Stockhoff Memorial Nursing Home
All providers in Fredericktown, MO · Long Term Care Pharmacy in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 10, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.