Active NPI
Carroll Cnty Mem Hosp Pharmacy Inc
Doing business as Carroll County Mem Hosp Phcy
- Institutional Pharmacy
- Carrollton, MO
National Provider Identifier
1942316708
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Institutional Pharmacy
- License
- 21044
- Legal business name
- CARROLL CNTY MEM HOSP PHARMACY INC
- Doing business as
- Carroll County Mem Hosp Phcy
- Practice address
- 1502 N Jefferson St
Carrollton, MO 64633-1948 - Phone
- (660) 542-1695
- Fax
- (660) 542-0363
- NPI assigned
- Aug 22, 2006
- Last updated
- Aug 22, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Jerry Dover
- Title
- Ceo
- Phone
- (660) 542-1695
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Institutional Pharmacy | 3336I0012X | |||
| Institutional Pharmacy | 3336I0012X | 21044 | MO | Primary |
Addresses
Primary practice location
1502 N Jefferson St
Carrollton, MO 64633-1948
Mailing address
1502 N Jefferson St
Carrollton, MO 64633-1948
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0909150 | Medicaid | MO | |
| 2623266 | Other | OTHER ID NUMBER-COMMERCIAL NUMBER |
Other names 1
- CARROLL COUNTY MEM HOSP PHCY
National Provider Directory
National Provider Directory- Tax ID family
- Carroll County Medical
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Critical Access Hospital
- Carrollton, MO
- NPI 1952557399
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156204800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1942316708",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1502 N JEFFERSON ST",
"city": "CARROLLTON",
"state": "MO",
"postal_code": "646331948"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1502 N JEFFERSON ST",
"city": "CARROLLTON",
"state": "MO",
"postal_code": "646331948",
"telephone_number": "660-542-1695",
"fax_number": "660-542-0363"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CARROLL CNTY MEM HOSP PHARMACY INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-08-22",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "DOVER",
"authorized_official_first_name": "JERRY",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "660-542-1695"
},
"taxonomies": [
{
"code": "3336I0012X",
"taxonomy_group": "",
"desc": "Pharmacy, Institutional Pharmacy",
"state": null,
"license": null,
"primary": false
},
{
"code": "3336I0012X",
"taxonomy_group": "",
"desc": "Pharmacy, Institutional Pharmacy",
"state": "MO",
"license": "21044",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0909150",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
"identifier": "2623266",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "CARROLL COUNTY MEM HOSP PHCY",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Carrollton, MO
- Mary Gail Bartholomew, R.PH.
- Norman Eugene Bliss, DC
- Board of Expanded Services (Five Acres Group Home)
- Brian Bree, M.D.
- Bristol Care, Inc.
- Carroll County Ambulance District
- Carroll County Health Department
- Carroll County Hospital Phtysicians
- Carroll County Medical Clinic
- Carroll County Memorial Hospital (Carroll County Memorial Hospital Home Health Care Agency)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.