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Contact Information

MEDLEY PHARMACY INC.
1903 E. 9TH ST.
TRENTON, MO64683
 Phone: 660-359-5700
 Fax: 660-359-5701
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Community/Retail Pharmacy

3336C0003X 58 Medical Supply Company with Pharmacist
 

Compounding Pharmacy

3336C0004X 58 Medical Supply Company with Pharmacist
 

Durable Medical Equipment & Medical Supplies

332B00000X 54 Other Medical Supply Company
 

Long Term Care Pharmacy

3336L0003X 58 Medical Supply Company with Pharmacist
 

Pharmacy

333600000X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for MEDLEY PHARMACY INC.

NPI # 1184941684
LBN Legal business name MEDLEY PHARMACY INC.
Authorized official AMY MITCHELL - (PRESIDENT)
Entity Organization
Organization subpart 1 Yes
Enumeration date 04/23/2010
Last updated 11/08/2024 - More than a year ago
Identifiers
MO License # 2010017621
MO Medicaid 606475200
Other 2124771 PK
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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