Midland Pharmacy

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

003480 Issued in MO

Legal business name

MIDLAND PHARMACY

Practice address

9628 Midland Blvd
Overland, MO 63114-3353

Phone

(314) 423-2000

NPI assigned

Apr 25, 2007

Last updated

Sep 12, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ft Couts

Title

Owner

Phone

(374) 429-7703

Specialties & licenses 2

Addresses

Other identifiers 2

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

{
    "created_epoch": "1177459200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1189555200000",
    "number": "1861611170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9628 MIDLAND BLVD",
            "city": "OVERLAND",
            "state": "MO",
            "postal_code": "631143353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9628 MIDLAND BLVD",
            "city": "OVERLAND",
            "state": "MO",
            "postal_code": "631143353",
            "telephone_number": "314-423-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDLAND PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-25",
        "last_updated": "2007-09-12",
        "status": "A",
        "authorized_official_last_name": "COUTS",
        "authorized_official_first_name": "FT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "374-429-7703"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MO",
            "license": "003480",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "2609191",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER",
            "identifier": "2609191",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Lovstad
• Phillip Mark Lueckenhoff, O.D.
• Libni Martinez
• Christina Meeker
• Memorial Home Services of Central Illinois, Inc
• Eisha Kaur Multani, OD
• Nickey & Co LLC
• Nickey & Co LLC (Nickey & Co. The Relaxation Spa)
• Riley O'Neill, RBT
• Overland Medical Center

• Community/Retail Pharmacy in Overland, MO
• Providers in Overland, MO by specialty
• Community/Retail Pharmacy in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2007; 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.