NPIMap

Organization Active NPI

Nuts

Doing business as Marionville Pharmacy

  • Community/Retail Pharmacy
  • Marionville, MO
National Provider Identifier
1891830238
Registry record updated Aug 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
005151 Issued in MO
Legal business name
NUTS
Doing business as
Marionville Pharmacy
Practice address
201 South U.S. Highway 60
Marionville, MO 65705
Phone
(417) 258-2526
Fax
(417) 463-2211
NPI assigned
Feb 21, 2007
Last updated
Aug 28, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2018

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

Authorized official

Name
John Victor Tonjuk, RPH.NPI 1750622551
Title
Pharmacist in Charge
Phone
(417) 258-2526

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 005151 MO Primary
Long Term Care Pharmacy 3336L0003X 005151 MO

Addresses

Primary practice location

201 South U.S. Highway 60
Marionville, MO 65705

Mailing address

PO Box 217
Marionville, MO 65705-0217
Phone (417) 258-2526

Other identifiers 2

IdentifierTypeStateIssuer
2629585OtherNCPDP NUMBER
601199508MedicaidMO

Other names 1

  • Marionville Pharmacy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Marionville Pharmacy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

  • Nuts Inc

    dba Marionville Pharmacy

    • Durable Medical Equipment & Medical Supplies
    • Marionville, MO
    • NPI 1992786511
    NPD tax ID

Practitioners & affiliated clinicians

Practitioners 1

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": "1172016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1535414400000",
    "number": "1891830238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 217",
            "city": "MARIONVILLE",
            "state": "MO",
            "postal_code": "657050217",
            "telephone_number": "417-258-2526",
            "fax_number": "417-463-2211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 SOUTH U.S. HIGHWAY 60",
            "city": "MARIONVILLE",
            "state": "MO",
            "postal_code": "65705",
            "telephone_number": "417-258-2526",
            "fax_number": "417-463-2211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NUTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-21",
        "last_updated": "2018-08-28",
        "status": "A",
        "authorized_official_last_name": "TONJUK",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "VICTOR",
        "authorized_official_title_or_position": "PHARMACIST IN CHARGE",
        "authorized_official_telephone_number": "417-258-2526",
        "authorized_official_credential": "RPH."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MO",
            "license": "005151",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "MO",
            "license": "005151",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP NUMBER",
            "identifier": "2629585",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "601199508",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Marionville Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Marionville Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Marionville, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2018; 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.