Medicine Shoppe of Dekalb Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

54010056 Issued in IL

Legal business name

MEDICINE SHOPPE OF DEKALB INC

Doing business as

The Medicine Stop

Practice address

810 S 4TH St
Dekalb, IL 60115-4410

Phone

(815) 758-8995

Fax

(815) 748-3784

NPI assigned

Oct 17, 2006

Organization subpart

No

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

Authorized official

Name

Robert Tamblyn, RPH

Title

Owner

Phone

(515) 758-8995

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• THE MEDICINE STOP Doing business as

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1267574400000",
    "number": "1952481277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "810 S 4TH ST",
            "city": "DEKALB",
            "state": "IL",
            "postal_code": "601154410",
            "telephone_number": "815-758-8995",
            "fax_number": "815-748-3784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 S 4TH ST",
            "city": "DEKALB",
            "state": "IL",
            "postal_code": "601154410",
            "telephone_number": "815-758-8995",
            "fax_number": "815-748-3784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICINE SHOPPE OF DEKALB INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-17",
        "last_updated": "2010-03-03",
        "status": "A",
        "authorized_official_last_name": "TAMBLYN",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "515-758-8995",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "IL",
            "license": "54010056",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "1449429",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "THE MEDICINE STOP",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Amanda Lee McCumsey
• Myles McGhee
• Mark McGuire, M.D.
• Patrick McMillion
• Natalie R Meckstroth, MA, ATC
• Kristen Angela Melchiori, MSW, CADC
• Alexis Melendez
• Jennifer S Mellin, MD
• Jazlynn Mendoza
• Samantha Mendoza

• Community/Retail Pharmacy in Dekalb, IL
• Providers in Dekalb, IL by specialty
• Community/Retail Pharmacy in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2010; 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.