THE MEDICINE SHOPPE PHARMACY
NPI 1790034064
Pharmacy - Community/Retail Pharmacy in Pevely, MO

Q: What is Pevely Rx's NPI number?

The NPI number for Pevely Rx is 1790034064. It was assigned to this organization in the NPPES registry on September 2, 2012. The provider is doing business as The Medicine Shoppe Pharmacy.

Q: What is Pevely Rx's specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Community/Retail Pharmacy, with taxonomy code 3336C0003X.

Q: When was this NPI record last updated?

The NPPES record for Pevely Rx was last updated on June 10, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since September 02, 2012CLIA 26D2048223 · Waiver

8640 COMMERCIAL BLVD, PEVELY, MO 63070(636) 479-6100(636) 479-6101 Get Directions Write a Review

NPPES record last updated: June 10, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jun 10, 2024, Mar 13, 2019 (2 updates tracked since 2019).

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About The Medicine Shoppe Pharmacy NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

THE MEDICINE SHOPPE PHARMACY (NPI 1790034064) is a healthcare organization registered as a community/retail pharmacy in Pevely, Missouri and active in the NPI registry since September 2012. The organization holds a CLIA Waiver certificate valid through October 10, 2026 and lists Jason Alexander Wang, President, as its authorized official.

NPPES Registry Identity

NPI1790034064

Entity TypeOrganization

Primary Taxonomy3336C0003X

Legal Business NamePEVELY RX

Location Address8640 COMMERCIAL BLVDPevely, MO 63070-1529

Mailing Address8640 Commercial BlvdPevely, MO 63070-1529 · (636) 479-6100 · Fax (636) 479-6101

Phone(636) 479-6100

Fax(636) 479-6101

Organization SubpartNo

Authorized OfficialJason Alexander WangPresident · (314) 753-8851

Enumeration DateSeptember 2, 2012

Last NPPES UpdateJune 10, 20242 updates tracked since enumeration

NPPES CertifiedJune 10, 2024

✔ NPI 1790034064 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers

Taxonomy Code3336C0003X

License✔ Licensed in MO · 2012030942

Definition

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.

Also ListedPharmacy · Compounding PharmacyTaxonomy 3336C0004X

Also ListedPharmacy · Long Term Care PharmacyTaxonomy 3336L0003X

8640 COMMERCIAL BLVD, Pevely, MO 63070

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Other Names 1

Doing Business AsThe Medicine Shoppe Pharmacy

Other Identifiers 2

Other2136810Pk

Medicaid606585404MO

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter from Arizona Complete Health and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 26D2048223

Pevely Rx Inc Dba Medicine Shoppe 1985 · Pevely, MO

Active · expires Oct 10, 2026

CLIA Number26D2048223

Laboratory TypePharmacy

Certificate Effective DateOctober 11, 2024

Certificate Expiration DateOctober 10, 2026

Laboratory DirectorJason Wang

Laboratory Phone(636) 479-6100

Laboratory LocationPevely Rx Inc Dba Medicine Shoppe 1985Jason Wang Pharm D 8640 Commercial Blvd, Pevely, MO 63070

CLIA data matches this NPI record on: Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 3

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Administration of influenza virus vaccine G0008

The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.

169 services169 patients

Influenza vaccine split virus, preservative free 90662

The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.

110 services110 patients

Administration of pneumococcal vaccine G0009

The pneumococcal vaccine helps protect against pneumococcal bacteria, which can cause severe infections like pneumonia and meningitis. The vaccine is given as an injection, typically in the arm. It's recommended for infants, older adults, and those with certain health conditions.

11 services11 patients

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

PEVELY RX

Pharmacy (Long Term Care Pharmacy)