MLM PHARMACY, INC. (NPI# 1285728691) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285728691 |
| Entity Type | Organization |
| Organization Name | MLM PHARMACY, INC. |
| Other Organization Name | MEDICINE SHOPPE PHARMACY |
| Practice Address |
215 N Broadway Ave Salem IL 62881-1511 |
| Practice Telephone | 6185480070 |
| Practice Fax Number | 6185489846 |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2014-05-27 |
| Authorized Official Name | MICHAEL MORTON (OWNER) |
| Authorized Official Telephone | 6185480070 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332BX2000X |
Durable Medical Equipment & Medical Supplies Specialization: Oxygen Equipment & Supplies |
IL | Suppliers | |
| N | 332BP3500X |
Durable Medical Equipment & Medical Supplies Specialization: Parenteral & Enteral Nutrition |
IL | Suppliers | |
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | IL | Suppliers | |
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
054014788 | IL | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | DEA # | BM7921908 | 01 |
| OTHER ID NUMBER-COMMERCIAL NUMBER | 1448530 | 01 |
| Other Name | Type Code |
|---|---|
| MEDICINE SHOPPE PHARMACY | Doing Business As Name - Organization |
| Street Address |
215 N BROADWAY AVE |
| City | SALEM |
| State | IL |
| Zip Code | 62881-1511 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295004661 | Michael Craig Morton | Pharmacist | 215 N Broadway Ave, Salem, IL 62881-1511 | 2011-12-14 |
| 1245509603 | Michael Lynn Morton | Pharmacist | 215 N Broadway Ave, Salem, IL 62881-1511 | 2011-12-14 |
| 1043408743 | My Urban Clinic, Inc | Clinic/Center | 215 N Broadway Ave, Salem, IL 62881-1511 | 2007-10-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447776026 | Heather Krajefska | Speech-Language Pathologist | Franklin Park School, 1325 N Franklin, Salem, IL 62881 | 2017-08-16 |
| 1629510581 | Heidi V. Thompson | Nurse Practitioner | 1250 W. Whittaker, Salem, IL 62881 | 2016-11-09 |
| 1548664170 | Catherine Durbin | Nurse Practitioner | 518 South Broadway, Salem, IL 62881 | 2014-10-10 |
| 1770718439 | Community Resource Center, Inc | Community/Behavioral Health | 315 Westgate, Salem, IL 62881 | 2009-05-26 |
| 1932377652 | Community Resource Center Inc | Clinic/Center | 315 Westgate Ave, Salem, IL 62881 | 2008-02-15 |
| 1245408053 | The Manor At Salem Woods, L.p. | Assisted Living Facility | 441 S. Hotze Rd., Salem, IL 62881 | 2008-02-14 |
| 1366610321 | Penta Group Inc. | Non-emergency Medical Transport (VAN) | 300 Schoonover Drive, Salem, IL 62881 | 2008-02-13 |
| 1326192808 | Alan D Montgomery | Optometrist | 400 North Broadway, Salem, IL 62881 | 2007-01-22 |
| 1669539979 | Knevitt Inc | Ambulance | 3340 Selmaville Rd, Salem, IL 62881 | 2007-01-03 |
| 1447314737 | Gautam Jha | Internal Medicine | 1325 W. Whittaker, Suite D, Salem, IL 62881 | 2006-12-20 |
| Find all providers in zip 62881 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. |
| 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] |
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| 1760859367 | Quisenberry Health System Pharmacy, LLC | Pharmacy | 148 Liberty St Se, Salem, OR 97301-3506 | 2015-08-31 |
| 1649306531 | Benignity LLC Dba Fort Lewis Pharmacy | Pharmacy | 2246 West Main St, Salem, VA 24153 | 2007-02-26 |
| 1316047749 | Cvs Pharmacy Inc | Pharmacy | 272 Highland Ave, Salem, MA 01970-1832 | 2006-09-25 |
| 1366542318 | Guffeys Pharmacy Inc | Pharmacy | 172 Hwy 62 E, Suite 2, Salem, AR 72576-0155 | 2006-09-22 |
| 1487753836 | Cvs Pharmacy Inc | Pharmacy | 200 Essex St, Salem, MA 01970-3705 | 2006-09-22 |
| 1730288184 | Cvs Pharmacy Inc | Pharmacy | 426b Essex St, Salem, MA 01970-3152 | 2006-09-22 |
| 1982707618 | Virginia Cvs Pharmacy, L.L.C. | Pharmacy | 179 Electric Rd, Salem, VA 24153-4432 | 2006-09-07 |
| Find all providers in SALEM | ||||
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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.