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Organization

MEDLEY PHARMACY INC

Active
Parent organization
MEDLEY PHARMACY, INC.
Other names
EverCare Pharmacy LTC
Organization subpart
Yes

Provider details

NPI number
Legal business name
MEDLEY PHARMACY, INC.
Authorized official
MRS. AMY MITCHELL (PRESIDENT)
(573) 885-0885
Entity
Organization

Contact information

Practice address
21748 US HIGHWAY 65, PRINCETON, MO 64673
(660) 748-4048
(660) 748-4044
Mailing address
330 N. FRANKLIN, PO BOX, CUBA, MO 65453
(573) 885-0885
(573) 677-0567

Taxonomy

Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
3336C0004X
Compounding Pharmacy
3336L0003X
Long Term Care Pharmacy

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2019013879
STATE PHARMACY LICENSE
MO
01
2500053848
STATE CONTROLLED SUBSTANCE BNDD
MO
05
600068902
MO
Enumeration date
04/11/2022
Last updated
11/08/2024
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