MADISON MEDICAL CENTER (NPI# 1801948880) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801948880 |
| Entity Type | Organization |
| Organization Name | MADISON MEDICAL CENTER |
| Other Organization Name | MADISON MEDICAL CENTER PHARMACY |
| Practice Address |
611 W Main St Fredericktown MO 63645-1111 |
| Mailing Address |
611 W Main St Po Box 431 Fredericktown MO 63645-1111 |
| Practice Telephone | 5737831047 |
| Practice Fax Number | 5737831063 |
| Enumeration Date | 2007-01-18 |
| Last Update Date | 2016-10-10 |
| Authorized Official Name | LINDA HATCH (PHARMACY DIRECTOR) |
| Authorized Official Telephone | 5737831047 |
| Authorized Official Credential | RPH |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers | ||
| N | 3336I0012X |
Pharmacy Specialization: Institutional Pharmacy |
Suppliers | ||
| Y | 3336L0003X |
Pharmacy Specialization: Long Term Care Pharmacy |
003980 | MO | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 010155109 | 05 | |
| PK | 2050238 | 01 | |
| MO | 601458003 | 05 |
| Other Name | Type Code |
|---|---|
| MADISON MEDICAL CENTER PHARMACY | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033115548 | Madison Medical Center | Clinic/Center | 13409 E 14 Mile Rd, Sterling Hts, MI 48312-6304 | 2005-06-21 |
| 1669514436 | Madison Medical Center | Emergency Medicine | 611 W Main St, Fredericktown, MO 63645-1111 | 2007-02-12 |
| 1245305408 | Madison Medical Center | Durable Medical Equipment & Medical Supplies | 611 W Main St, Fredericktown, MO 63645-1111 | 2006-11-22 |
| Street Address |
611 W MAIN ST |
| City | FREDERICKTOWN |
| State | MO |
| Zip Code | 63645-1111 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548235419 | Ashvin D. Patel | Emergency Medicine | 611 W Main St, Fredericktown, MO 63645-1111 | 2006-02-22 |
| 1306402680 | Alanna Guess | Nurse Practitioner | 611 W Main St, Fredericktown, MO 63645-1111 | 2019-05-13 |
| 1225487143 | Heather Cheaney | Clinical Nurse Specialist | 611 W Main St, Fredericktown, MO 63645-1111 | 2016-06-10 |
| 1225355027 | Craig J. Millham | Mechanotherapist | 611 W Main St, Fredericktown, MO 63645-1111 | 2010-05-03 |
| 1154648954 | Michele Rubel | Mechanotherapist | 611 W Main St, Fredericktown, MO 63645-1111 | 2010-05-03 |
| 1760630032 | Madison County Ambulance District | Ambulance | 611 W Main St, Fredericktown, MO 63645-1111 | 2008-08-28 |
| 1558545871 | Corinna D Defrancesco | Nurse Practitioner | 611 W Main St, Fredericktown, MO 63645-1111 | 2007-12-21 |
| 1780802512 | Susan Lee Krydynski | Occupational Therapist | 611 W Main St, Fredericktown, MO 63645-1111 | 2007-04-24 |
| 1669514436 | Madison Medical Center | Emergency Medicine | 611 W Main St, Fredericktown, MO 63645-1111 | 2007-02-12 |
| 1104973858 | Nancy D Lodge | Pediatrics | 611 W Main St, Fredericktown, MO 63645-1111 | 2007-01-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093193880 | Emily Engers | Counselor | 206 W Marvin Ave, Fredericktown, MO 63645 | 2015-05-12 |
| 1871823955 | Covenant Care Services, LLC | Custodial Care Facility | 1610 W. Hwy 72, Fredericktown, MO 63645 | 2010-01-12 |
| 1518110279 | East Missouri Action Agency, Inc. | Clinic/Center | 806 West College Rd, Fredericktown, MO 63645 | 2008-10-28 |
| 1679737324 | Linda Carole Cravens | Dentist | 731 W Main St, Guy A Walker Dds, Fredericktown, MO 63645 | 2008-07-11 |
| 1629286976 | Community Health Care Associates, Inc | Social Worker | 735 West Main, Fredericktown, MO 63645 | 2007-05-18 |
| 1467539031 | Madison Medical Center Stockhoff Memorial Nursing Home | Clinic/Center | 611 West Main Street, Fredericktown, MO 63645 | 2006-11-01 |
| 1487749537 | Covenant Care Services, LLC | Registered Nurse | 120 S. Mine Lamotte, Fredericktown, MO 63645 | 2006-10-04 |
| 1215577945 | Modern Mental Health | Community/Behavioral Health | 151 South Main Street, Suite B, Fredericktown, MO 63645 | 2020-01-10 |
| 1235392309 | Humberto Jose Olivero Lara | Family Medicine | 611 West Main Street, Fredericktown, MO 63645 | 2008-07-08 |
| 1003983859 | Madison Memorial Hospital Stockhoff Memorial Nursing Home | Pharmacy | 611 West Main Street, Fredericktown, MO 63645 | 2006-11-29 |
| Find all providers in zip 63645 | ||||
| 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 |
|---|---|---|---|---|
| 1265033534 | Good Graces, LLC | Pharmacy | 857 E Main Street, Ste 3 - 5, Willow Springs, MO 65793 | 2020-11-03 |
| 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 | ||||
| City | FREDERICKTOWN |
| Zip Code | 63645 |
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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.