MEDLEY PHARMACY INC — NPI 1922252634 (Licensed & Credentialed Suppliers — Pharmacy, Community

CMS-1500 Box 24J / 33a • NPI

1922252634

Type 2 Organization (Box 32a/33a)

HIPAA NUCC Taxonomy • CMS Code

3336C0003X (CMS 58)

Licensed & Credentialed Suppliers — Pharmacy, Community — Retail Pharmacy

Box 32 Service Location & ZIP+4

733 W SPRINGFIELD AVE, GERALD, MO, 63037-2135

✓ 9-Digit EDI 837 ZIP+4 (63037-2135)

Practice Phone & Referral Fax

(573) 764-5980

Fax: (573) 764-5982

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1922252634 (MEDLEY PHARMACY INC) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

Institutional Type-2 NPI facilities enroll via CMS-855A institutional provider agreements rather than individual Order & Referring PECOS.

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1922252634` (NPI-2 Organization / Facility)
Provider / Legal Name	MEDLEY PHARMACY INC
Plain-English Specialty	Licensed & Credentialed Suppliers — Pharmacy, Community — Retail Pharmacy NUCC Code: `3336C0003X` (Pharmacy, Community/Retail Pharmacy)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	733 W SPRINGFIELD AVE, GERALD, MO, 63037-2135
Practice Telephone / Fax	Tel: (573) 764-5980 \| Fax: (573) 764-5982
Administrative Mailing Address	PO BOX 528, CUBA, MO, 65453-0528
Enumeration & Last Sync	Enumerated: 2008-11-07 \| CMS Record Updated: 2022-09-12
Authorized Official	LOCAL HEALTH MISSOURI INC (OWNER)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

733 W SPRINGFIELD AVE, GERALD, MO, 63037-2135

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Plain-English Taxonomy & CMS Crosswalk (3336C0003X)

What Does Taxonomy Code 3336C0003X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 3336C0003X translates to:
"Licensed & Credentialed Suppliers — Pharmacy, Community — Retail Pharmacy"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 58 (Medical Supply Company with Pharmacist) • CMS Code A5 (Pharmacy)
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Pharmacy, Community/Retail Pharmacy for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (MEDLEY PHARMACY INC)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`332B00000X` — Durable Medical Equipment & Medical Supplies Plain English: Licensed & Credentialed Suppliers — Durable Medical Equipment & Medical Supplies	State: N/A \| License: `Verified` \| Primary: Secondary
`333600000X` — Pharmacy Plain English: Licensed & Credentialed Suppliers — Pharmacy	State: N/A \| License: `Verified` \| Primary: Secondary
`3336L0003X` — Pharmacy, Long Term Care Pharmacy Plain English: Licensed & Credentialed Suppliers — Pharmacy, Long-term Care Pharmacy	State: N/A \| License: `Verified` \| Primary: Secondary
`3336C0003X` — Pharmacy, Community/Retail Pharmacy Plain English: Licensed & Credentialed Suppliers — Pharmacy, Community — Retail Pharmacy	State: MO \| License: `2008034039` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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MEDLEY PHARMACY INC (NPI #1922252634)