BROADWAY LTC, LLC (NPI# 1457758153) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457758153 |
| Entity Type | Organization |
| Organization Name | BROADWAY LTC, LLC |
| Other Organization Name | BROADWAY PHARMACY LTC |
| Practice Address |
37 Doctors Park Ste 7 Cape Girardeau MO 63703 |
| Mailing Address |
710 Broadway St Cape Girardeau MO 63701-5514 |
| Practice Telephone | 5738032040 |
| Mailing Telephone | 5733358207 |
| Mailing Fax Number | 5733354904 |
| Enumeration Date | 2014-11-24 |
| Last Update Date | 2018-07-24 |
| Authorized Official Name | KEVIN WOOD (DIRECTOR OF PHARMACY) |
| Authorized Official Telephone | 5735763029 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336L0003X |
Pharmacy Specialization: Long Term Care Pharmacy |
PS2014040344 | MO | Suppliers |
| Other Name | Type Code |
|---|---|
| Broadway Pharmacy LTC | Doing Business As Name - Organization |
| Street Address |
37 DOCTORS PARK STE 7 |
| City | CAPE GIRARDEAU |
| State | MO |
| Zip Code | 63703 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720566102 | Christian Torres Diaz | Dentist | 3070 William Street, Cape Girardeau, MO 63703 | 2018-07-30 |
| 1336562263 | Rachel Speer | Community Health Worker | 20 South Sprigg St, Cape Girardeau, MO 63703 | 2014-01-29 |
| 1245653120 | Mary Wilburn | Community Health Worker | 20 S Spigg, Cape Girardeau, MO 63703 | 2014-01-28 |
| 1831523695 | Saint Francis Medical Center | General Acute Care Hospital | 150 South Mount Auburn Road, Suite 342, Cape Girardeau, MO 63703 | 2013-08-29 |
| 1033481163 | J K Essmyer Medical Services LLC | Clinic/Center | 300 Mt Auburn Rd, Auburn Surgery Center, Inc, Cape Girardeau, MO 63703 | 2012-02-06 |
| 1477867844 | Drx - East Missouri Providers, P.C. | Family Medicine | 465 S Mount Auburn Road, Suite 103, Cape Girardeau, MO 63703 | 2010-07-28 |
| 1346564879 | Richard William Tobey | Family Medicine | 3250 Gordonville Rd Ste 301, Cape Girardeau, MO 63703 | 2010-03-26 |
| 1144413568 | Stephanie Danette Miller | Family Medicine | 817 S. Mount Auburn, Suite 100, Southeast Primary Care, Cape Gerardeau, MO 63703 | 2007-08-20 |
| 1437349305 | Shanaree Mae Muzinich | Radiology | 70 Doctor's Park, Cape Girardeau, MO 63703 | 2007-07-27 |
| 1629270194 | John T Lake | Psychiatry & Neurology | 60 Doctors Park Lowr Level, Cape Girardeau, MO 63703 | 2007-06-05 |
| Find all providers in zip 63703 | ||||
| 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 |
|---|---|---|---|---|
| 1497266472 | Schnuck Markets Inc | Pharmacy | 19 S Kingshighway St Ste B, Cape Girardeau, MO 63703-5742 | 2017-10-18 |
| 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 |
| 1780229690 | Dalpoas Group Inc | Pharmacy | 4245 Forest Park Ave Ste B, Saint Louis, MO 63108-2810 | 2019-11-14 |
| 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 |
| Find all providers with the same taxonomy | ||||
| City | CAPE GIRARDEAU |
| Zip Code | 63703 |
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| 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.