National Provider Identifier Database

MADISON MEDICAL CENTER
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.


Contact Information

MADISON MEDICAL CENTER
611 W MAIN ST
FREDERICKTOWN, MO63645-1111
Phone: 573-783-1047
Fax: 573-783-1063
Website:
Specialty Taxonomy Code
* Long Term Care Pharmacy 3336L0003X
Community/Retail Pharmacy 3336C0003X
Institutional Pharmacy 3336I0012X

* Indicates primary specialty

NPI Profile & details for MADISON MEDICAL CENTER

NPI Number 1801948880
Legal business name
LBN
MADISON MEDICAL CENTER
Authorized official LINDA HATCH - (PHARMACY DIRECTOR)
Entity Organization
Organization subpart No
Enumeration date 01/18/2007
Last updated 10/10/2016 - About 10 years ago
Sole proprietor1 Not specified
Identifiers
  • MO License #: 003980
  • MO Medicaid: 010155109
  • MO Medicaid: 601458003
  • Other: 2050238 PK

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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