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General NPI Number Information
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NPI Number | 1184941684
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Entity Type | Organization
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Legal Business Name | MEDLEY PHARMACY INC.
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Dates
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Enumeration Date | 04/23/2010
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Last Update Date | 11/08/2024
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Provider Practice Location Address
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Address Line | 1903 E. 9TH ST.
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City | TRENTON
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State | MO
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Zip | 64683
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Country | US
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Telephone | 660-359-5700
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Fax | 660-359-5701
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Provider Business Mailing Address
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Address Line | 330 N. FRANKLIN PO BOX 528
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City | CUBA
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State | MO
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Zip | 65453
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Country | US
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Telephone | 573-885-0885
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Fax | 573-677-0567
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. AMY MITCHELL
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Credential |
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Telephone | 573-885-0885
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 2010017621
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License Number State | MO
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Taxonomy #4
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Taxonomy Code | 3336C0004X
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Taxonomy Name | Compounding Pharmacy
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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