OLD TOWN PHARMACY LLC (NPI# 1578754701) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578754701 |
| Entity Type | Organization |
| Organization Name | OLD TOWN PHARMACY LLC |
| Other Organization Name | OLD TOWN PHARMACY |
| Practice Address |
100a Chapel Drive Monett MO 65708 |
| Mailing Address |
100a Chapel Dr Monett MO 65708 |
| Practice Telephone | 4176351100 |
| Practice Fax Number | 4176351103 |
| Mailing Telephone | 4176351100 |
| Mailing Fax Number | 4176351103 |
| Enumeration Date | 2007-08-05 |
| Last Update Date | 2020-01-22 |
| Authorized Official Name | MR. SHANE MICHAEL BECKER (OWNER/MANAGER/PIC) |
| Authorized Official Telephone | 4176351100 |
| Authorized Official Credential | PHARMD RPH |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
2007022497 | MO | Suppliers |
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
2014010847 | MO | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NCPDP | 2637506 | 01 | |
| MO | 19735928 | 05 | |
| MO | PHARMACY LIC | 2007022497 | 01 |
| DEA | FO0411897 | 01 |
| Other Name | Type Code |
|---|---|
| Old Town Pharmacy | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437789237 | Old Town Pharmacy LLC | Pharmacy | 100 Chapel Dr Ste A, Monett, MO 65708-9378 | 2020-01-21 |
| Street Address |
100A CHAPEL DRIVE |
| City | MONETT |
| State | MO |
| Zip Code | 65708 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053927228 | Cox- Monett Hospital, Inc. | Family Medicine | 1000 E Hwy 60, Monett, MO 65708 | 2020-09-22 |
| 1629432182 | Clark Community Mental Health Center | Clinic/Center | 1701 N Central Ave, Monett, MO 65708 | 2016-04-11 |
| 1386010767 | Kathleen Josef Cook | Physical Therapist | 700 E. Cleveland Ave., Monett, MO 65708 | 2015-08-19 |
| 1427443829 | Jeremy Cash Graddy | Physical Therapist | 864 E Us Hwy 60, Suite A, Monett, MO 65708 | 2015-04-02 |
| 1871925529 | Kimberly K Mundt | Counselor | 1701 N Central Ave., Monett, MO 65708 | 2013-08-05 |
| 1114269776 | Amy J Cole | Counselor | 1701 N. Central, Monett, MO 65708 | 2013-03-21 |
| 1538444120 | Brenda Kay Barger-saunders | Respiratory Therapist, Certified | 807 North Lincoln Avenue, Asthma Education Program, Monett, MO 65708 | 2011-10-15 |
| 1164752622 | Clark Community Mental Health Center | Clinic/Center | 1701 North Central St, Monett, MO 65708 | 2010-01-06 |
| 1497918320 | Clark Community Mental Health Center | Counselor | 1701 North Central Ave, Monett, MO 65708 | 2008-07-10 |
| 1295929644 | Apex Physical Therapy, LLC | Clinic/Center | 100 Chapel Drive, Suite C, Monett, MO 65708 | 2007-08-29 |
| Find all providers in zip 65708 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| 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. |
| 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 |
|---|---|---|---|---|
| 1336285121 | Bruners Monett Pharmacy Inc | Pharmacy | 321 E Broadway St, Monett, MO 65708-2329 | 2007-01-29 |
| 1548321805 | Monett Professional Pharmacy | Pharmacy | 801 N Lincoln Ave, Monett, MO 65708-1641 | 2006-12-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699374629 | Curators of The University of Missouri | Pharmacy | 7115 East St. Charles Road, Columbia, MO 65202 | 2020-10-21 |
| 1376141143 | Phillips Pharmacy, LLC | Pharmacy | 7278 State Highway 14 E, Sparta, MO 65753-9345 | 2020-10-14 |
| 1013527761 | Rpcs, Inc. | Pharmacy | 18128 State Hwy 13, Branson West, MO 65737 | 2020-08-07 |
| 1205446184 | Rpcs, Inc. | Pharmacy | 200 Southtowne Blvd, Hollister, MO 65672-9610 | 2020-08-05 |
| 1912517897 | Rpcs, Inc. | Pharmacy | 1447 State Highway 248 Ste J, Branson, MO 65616-8161 | 2020-08-05 |
| 1245849801 | Rpcs Inc | Pharmacy | 163 W Old Mill Rd, Fair Grove, MO 65648-7918 | 2020-07-29 |
| 1760005219 | Meta Pharmacy Solutions | Pharmacy | 108 Triad Ctr W, O Fallon, MO 63366-7541 | 2020-05-19 |
| 1437778172 | Harps Food Stores, Inc | Pharmacy | 707 Specialty Dr, Dexter, MO 63841-2718 | 2020-04-13 |
| 1013540038 | Auburn Pharmacy Inc | Pharmacy | 810 W 35th St Ste 101, Higginsville, MO 64037-1865 | 2020-02-18 |
| 1801428495 | Scpg Missouri LLC | Pharmacy | 501 South Madison Ave, Suite S, Webb City, MO 64870 | 2020-02-11 |
| Find all providers with the same taxonomy | ||||
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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.