STATE OF MISSOURI (NPI# 1376682708) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376682708 |
| Entity Type | Organization |
| Organization Name | STATE OF MISSOURI |
| Other Organization Name | ST LOUIS PRC PHARMACY |
| Practice Address |
5300 Arsenal St Saint Louis MO 63139-1463 |
| Mailing Address |
1706 E Elm St Jefferson City MO 65101-4130 |
| Practice Telephone | 3148776500 |
| Practice Fax Number | 3148775982 |
| Mailing Telephone | 5737513398 |
| Mailing Fax Number | 5735264560 |
| Enumeration Date | 2007-02-05 |
| Last Update Date | 2020-10-27 |
| Authorized Official Name | MOLLY JANE BOECKMANN (DIRECTOR OF ADMINISTRATIVE SERVICES) |
| Authorized Official Telephone | 5737514055 |
| Is Organization Subpart | Y |
| Parent Organization Name | STATE OF MISSOURI |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336L0003X |
Pharmacy Specialization: Long Term Care Pharmacy |
Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NCPDP | 2611324 | 01 |
| Other Name | Type Code |
|---|---|
| St Louis PRC Pharmacy | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437781499 | State of Missouri | Rehabilitation Counselor | 3418 Knipp Dr, Jefferson City, MO 65109-5701 | 2020-02-07 |
| 1275073280 | State of Missouri | General Practice | 1547 W Commerce Drive, Marshall, MO 65340-3907 | 2017-02-24 |
| 1528333085 | State of Missouri | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1000 N Colorado St, Nevada, MO 64772-1618 | 2012-03-16 |
| 1386843621 | State of Missouri | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 15555 Little Blue Rd, Kansas City, MO 64139 | 2007-07-17 |
| 1922207679 | State of Missouri | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 5410 Rinker Rd, Kansas City, MO 64129-2308 | 2007-07-13 |
| 1760681415 | State of Missouri | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1501 N River Blvd, Independence, MO 64050-1760 | 2007-07-13 |
| 1164630463 | State of Missouri | Intermediate Care Facility, Mentally Retarded | 11 Brady Cir, Overland, MO 63114-1110 | 2007-05-18 |
| 1548322605 | State of Missouri | Day Training, Developmentally Disabled Services | 1500 Vandiver Dr Ste 100, Columbia, MO 65202-3932 | 2006-12-15 |
| 1366503153 | State of Missouri | Day Training, Developmentally Disabled Services | 471 E Slater St, Marshall, MO 65340 | 2006-12-13 |
| 1427118033 | State of Missouri | Day Training, Developmentally Disabled Services | 522 Star St, Marshall, MO 65340 | 2006-12-12 |
| Street Address |
5300 ARSENAL ST |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63139-1463 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427002013 | State of Missouri | Psychologist | 5300 Arsenal St, Saint Louis, MO 63139-1463 | 2006-05-19 |
| 1801336243 | Michelle Hoff | Nurse Practitioner | 5300 Arsenal St, Saint Louis, MO 63139-1463 | 2017-03-05 |
| 1356888663 | Andrew Claywell | Registered Nurse | 5300 Arsenal St, Saint Louis, MO 63139-1463 | 2017-01-24 |
| 1134663370 | Anthony Henke | Psychologist | 5300 Arsenal St, Saint Louis, MO 63139-1463 | 2016-12-07 |
| 1346630852 | State of Missouri Department of Mental Health | Psychiatric Hospital | 5300 Arsenal St, Saint Louis, MO 63139-1463 | 2015-02-04 |
| 1659776128 | Robert Schmitt | Pharmacist | 5300 Arsenal St, Saint Louis, MO 63139-1463 | 2014-10-27 |
| 1851669261 | Crista Marie Montgomery | Psychologist | 5300 Arsenal St, Saint Louis, MO 63139-1463 | 2011-12-13 |
| 1215173042 | Douglas Mccoy | Psychiatry & Neurology | 5300 Arsenal St, Saint Louis, MO 63139-1463 | 2008-12-29 |
| 1598966475 | Arthur Stuart Wieselthier | Dentist | 5300 Arsenal St, Saint Louis, MO 63139-1463 | 2007-05-30 |
| 1225249089 | State of Missouri | Case Management | 5300 Arsenal St, Saint Louis, MO 63139-1463 | 2007-05-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174160337 | Dawn Martina Clark | Social Worker | 1150 Graham Road, St. Louis, MO 63139 | 2019-12-06 |
| 1013479716 | Cerner Health Connections, Inc. | Pharmacy | 1403 Hampton Avenue, St. Louis, MO 63139 | 2019-04-02 |
| 1447699335 | Beth Renee Groenke | Dentist | 1403 Hampton Ave, St. Louis, MO 63139 | 2013-06-24 |
| 1295866648 | Occupational Health Centers of Kansas Pa | Clinic/Center | 6726 Manchester Road, St. Louis, MO 63139 | 2007-03-08 |
| 1912069733 | Daniel G Armbruster Dc PC | Acupuncturist | 2730 Watson Rd, St Louis, MO 63139 | 2006-12-15 |
| 1831250125 | Kathia Denise Betts | Counselor | 3309 S. Kingshighway Blvd., St.louis, MO 63139 | 2006-12-12 |
| 1841350220 | Denzel Dean Jines II | Dentist | 2340 Hampton Avenue, Suite 3, St. Louis, MO 63139 | 2006-12-08 |
| 1285718163 | Rakhshanda Hassan | Psychiatry & Neurology | St Louis Psychiatric Rehabilitation Center, 5300 Arsenal, St Louis, MO 63139 | 2006-10-25 |
| 1952490682 | City of St. Louis | Ambulance | 2634 Hampton Avenue, City of St Louis Emergency Medical Services, St Louis, MO 63139 | 2006-10-12 |
| 1104917434 | Select Physical Therapy Holdings Inc | Clinic/Center | 1900 South Hampton, St Louis, MO 63139 | 2006-09-28 |
| Find all providers in zip 63139 | ||||
| Taxonomy Code | 3336L0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | 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. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780229690 | Dalpoas Group Inc | Pharmacy | 4245 Forest Park Ave Ste B, Saint Louis, MO 63108-2810 | 2019-11-14 |
| 1326316969 | Gateway Apothecary | Pharmacy | 4473 Forest Park Ave, Saint Louis, MO 63108-2211 | 2011-12-11 |
| 1982901419 | Pharmacy Corporation of America | Pharmacy | 105 Arc Dr, Saint Louis, MO 63146-3502 | 2011-02-18 |
| 1518139534 | Everspring LLC | Pharmacy | 1884 Lackland Hill Pkwy Ste 6, Saint Louis, MO 63146-3569 | 2008-03-31 |
| 1578658571 | N-f Pharmacy, Inc | Pharmacy | 8 Crestwood Executive Ctr, Saint Louis, MO 63126-1904 | 2006-10-04 |
| 1780615393 | Gateway Rx LLC | Pharmacy | 2000 Westport Center Dr, Saint Louis, MO 63146-3564 | 2006-07-05 |
| 1801341292 | Car Pharmacy LLC | Pharmacy | 5378 Southwest Ave, Saint Louis, MO 63139-1446 | 2016-08-16 |
| 1619016862 | State of Missouri | Pharmacy | 5351 Delmar Blvd, Saint Louis, MO 63112-3146 | 2007-02-05 |
| 1730244161 | Imran Pharmacy | Pharmacy | 3737 N Kingshighway Blvd, Ste 100, Saint Louis, MO 63115-1736 | 2006-12-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265033534 | Good Graces, LLC | Pharmacy | 857 E Main Street, Ste 3 - 5, Willow Springs, MO 65793 | 2020-11-03 |
| 1780298406 | Healthdirect Institutional Pharmacy Services, Inc. | Pharmacy | 4083 N State Highway Nn, Ozark, MO 65721-7201 | 2020-09-01 |
| 1023620838 | Tipton Pharmacy | Pharmacy | 310 Us Highway 50 W, Tipton, MO 65081-8701 | 2020-08-21 |
| 1568095313 | Auburn Pharmacy, Inc. | Pharmacy | 1103 S 169 Hwy, Smithville, MO 64089 | 2020-02-20 |
| 1053953109 | Summers Pharmacy of Slater, LLC | Pharmacy | 102 E Maple St, Slater, MO 65349-1539 | 2019-10-10 |
| 1316594328 | Legacy Drugstore LLC | Pharmacy | 13000 Veterans Memorial Pkwy Ste A, Wright City, MO 63390-1012 | 2019-08-23 |
| 1972158673 | Hils Pharmacy Salisbury LLC | Pharmacy | 501 E. 24 Hwy Ste A, Salisbury, MO 65281 | 2019-08-08 |
| 1700342888 | Battlefield Pharmacy | Pharmacy | 4062 W Republic Rd, Battlefield, MO 65619-7108 | 2019-02-14 |
| 1548733769 | Guardian Pharmacy of St. Louis, LLC | Pharmacy | 926 S Highway Dr, Fenton, MO 63026-2023 | 2019-01-10 |
| 1346718418 | Gideon Pharmacy LLC | Pharmacy | 111 N Main St., Gideon, MO 63848 | 2018-11-07 |
| Find all providers with the same taxonomy | ||||
| City | SAINT LOUIS |
| Zip Code | 63139 |
Please comment or provide details below to improve the information on STATE OF MISSOURI.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.