MEDLEY PHARMACY (NPI# 1386112829) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386112829 |
| Entity Type | Organization |
| Organization Name | MEDLEY PHARMACY |
| Other Organization Name | LTC SINKS PHARMACY SOUTH |
| Practice Address |
1100b S Bishop Ave Rolla MO 65401-4418 |
| Mailing Address |
Po Box 528 330 N Franklin Cuba MO 65453-0528 |
| Practice Telephone | 5733084899 |
| Enumeration Date | 2018-11-02 |
| Last Update Date | 2019-03-26 |
| Authorized Official Name | SANDRA MITCHELL (PRESIDENT) |
| Authorized Official Telephone | 5738850885 |
| Authorized Official Credential | PHARM D |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336L0003X |
Pharmacy Specialization: Long Term Care Pharmacy |
Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 604007401 | 05 | |
| MO | 624007407 | 05 |
| Other Name | Type Code |
|---|---|
| LTC SINKS PHARMACY SOUTH | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053431726 | Medley Pharmacy | Durable Medical Equipment & Medical Supplies | 601 E. Hwy. 28, Owensville, MO 65066-0528 | 2007-03-29 |
| 1447728985 | Medley Pharmacy | Pharmacy | 200 N Franklin St, Cuba, MO 65453-1705 | 2018-11-02 |
| 1144798679 | Medley Pharmacy | Pharmacy | 1375 E 10th St Ste B, Rolla, MO 65401-3591 | 2018-11-02 |
| Street Address |
1100B S BISHOP AVE |
| City | ROLLA |
| State | MO |
| Zip Code | 65401-4418 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740385608 | Medley Pharmacy Inc | Durable Medical Equipment & Medical Supplies | 1100b S Bishop Ave, Rolla, MO 65401-4418 | 2006-09-14 |
| 1316333958 | Hillcrest Drug Inc | Eyewear Supplier (Equipment, not the service) | 1100b S Bishop Ave, Rolla, MO 65401 | 2015-04-10 |
| 1700906591 | Sinks Pharmacy South | Pharmacy | 1100b S Bishop Ave, Rolla, MO 65401-4418 | 2007-03-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639645591 | Samantha Jo Mitchell | Pharmacist | 1375 E 10th St Suite B, Rolla, MO 65401 | 2018-10-18 |
| 1427567726 | Gerry Wade Funkhouser Jr. | Counselor | 103 W 10th St, Rolla, MO 65401 | 2017-09-29 |
| 1366967960 | Shana Hintz Wisniewski | Social Worker | 1000 W. 10th St., Rolla, MO 65401 | 2017-08-04 |
| 1174066559 | Tabitha Hundt | Counselor | 1011 Cypress Dr, Rolla, MO 65401 | 2016-12-02 |
| 1841742855 | Alpha Assisted Living LLC | Assisted Living Facility | 13450 Cr 7040, 803 E 12th St, Rolla, MO 65401 | 2016-10-26 |
| 1275916884 | Elizabeth Zersen | Occupational Therapist | 2053 Vienna Rd, Rolla, MO 65401 | 2015-06-30 |
| 1386047025 | Becky L Witham | Nurse Practitioner | 1060 W 10th Street, Rolla, MO 65401 | 2014-10-08 |
| 1114326121 | Summer Adey | Licensed Practical Nurse | 13750 State Route F, Rolla, MO 65401 | 2014-08-14 |
| 1518303296 | Leaetta Mildred Gardner | Nursing Facility/Intermediate Care Facility | 13450 County Road 7040, Rolla, MO 65401 | 2013-05-21 |
| 1316282064 | Susan Peitz Gruener | Occupational Therapy Assistant | 1800 White Column Road, Rolla, MO 65401 | 2012-12-06 |
| Find all providers in zip 65401 | ||||
| Taxonomy Code | 3336L0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Long Term Care Pharmacy |
| A pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermediate care facilities for mentally retarded, hospice, assisted living facilities, group homes, and other forms of congregate living arrangements. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144798679 | Medley Pharmacy | Pharmacy | 1375 E 10th St Ste B, Rolla, MO 65401-3591 | 2018-11-02 |
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|---|---|---|---|---|
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| 1780298406 | Healthdirect Institutional Pharmacy Services, Inc. | Pharmacy | 4083 N State Highway Nn, Ozark, MO 65721-7201 | 2020-09-01 |
| 1023620838 | Tipton Pharmacy | Pharmacy | 310 Us Highway 50 W, Tipton, MO 65081-8701 | 2020-08-21 |
| 1568095313 | Auburn Pharmacy, Inc. | Pharmacy | 1103 S 169 Hwy, Smithville, MO 64089 | 2020-02-20 |
| 1780229690 | Dalpoas Group Inc | Pharmacy | 4245 Forest Park Ave Ste B, Saint Louis, MO 63108-2810 | 2019-11-14 |
| 1053953109 | Summers Pharmacy of Slater, LLC | Pharmacy | 102 E Maple St, Slater, MO 65349-1539 | 2019-10-10 |
| 1316594328 | Legacy Drugstore LLC | Pharmacy | 13000 Veterans Memorial Pkwy Ste A, Wright City, MO 63390-1012 | 2019-08-23 |
| 1972158673 | Hils Pharmacy Salisbury LLC | Pharmacy | 501 E. 24 Hwy Ste A, Salisbury, MO 65281 | 2019-08-08 |
| 1700342888 | Battlefield Pharmacy | Pharmacy | 4062 W Republic Rd, Battlefield, MO 65619-7108 | 2019-02-14 |
| 1548733769 | Guardian Pharmacy of St. Louis, LLC | Pharmacy | 926 S Highway Dr, Fenton, MO 63026-2023 | 2019-01-10 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.