MVPS LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

546 Issued in CO

Legal business name

MVPS LLC

Doing business as

JACKS MARKET PHARMACY
Jack's Market Pharmacy

Practice address

222 Solar Ave
Monte Vista, CO 81144-1066

Phone

(719) 852-9894

Fax

(719) 852-9897

NPI assigned

Jan 22, 2007

Organization subpart

No

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

Authorized official

Name

Matthew Hutera

Title

Managing Member

Phone

(651) 214-3762

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 2

• JACKS MARKET PHARMACY Doing business as
• Jack's Market Pharmacy Doing business as

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643328000000",
    "number": "1912051640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "903 87TH AVE",
            "city": "HUDSON",
            "state": "WI",
            "postal_code": "540167074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 SOLAR AVE",
            "city": "MONTE VISTA",
            "state": "CO",
            "postal_code": "811441066",
            "telephone_number": "719-852-9894",
            "fax_number": "719-852-9897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MVPS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-22",
        "last_updated": "2022-01-28",
        "certification_date": "2022-01-28",
        "status": "A",
        "authorized_official_last_name": "HUTERA",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "651-214-3762"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CO",
            "license": "546",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER",
            "identifier": "0618857",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "06674542",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "JACKS MARKET PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "JACKS MARKET PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Jack's Market Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Monte Vista Estates, LLC
• Monte Vista Eye Care Center Inc.
• Monte Vista Family Practice
• Monte Vista Investors, LLC
• MVPS LLC
• Janice Janae Naranjo, LPC
• Michael John Noonan, PA-C
• Terry Glenn Pace Jr., LPCC
• Amelie Mae Pacheco
• Pence Pediatrics, PC

• Community/Retail Pharmacy in Monte Vista, CO
• Providers in Monte Vista, CO by specialty
• Community/Retail Pharmacy in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2022; 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.