FOUR STATES APOTHECARY LLC (NPI# 1952876948) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952876948 |
| Entity Type | Organization |
| Organization Name | FOUR STATES APOTHECARY LLC |
| Practice Address |
102 S Main St Carl Junction MO 64834-1000 |
| Mailing Address |
413 Commercial St Oswego KS 67356-2017 |
| Practice Telephone | 4176497021 |
| Practice Fax Number | 4176496269 |
| Mailing Telephone | 6207952233 |
| Mailing Fax Number | 6207954910 |
| Enumeration Date | 2018-10-05 |
| Last Update Date | 2018-10-05 |
| Authorized Official Name | DR. MARK STEVEN MAYBERRY JR. (PHARMACY OWNDER) |
| Authorized Official Telephone | 4175291815 |
| Authorized Official Credential | PHARMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers |
| Other Name | Type Code |
|---|---|
| CJ Pharmacy | Doing Business As Name - Organization |
| Street Address |
102 S MAIN ST |
| City | CARL JUNCTION |
| State | MO |
| Zip Code | 64834-1000 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023065521 | Jerry E Botts | Pharmacist | 102 S Main St, Carl Junction, MO 64834-1000 | 2006-05-28 |
| 1629025127 | Bruner Drugs, Inc. | Pharmacy | 102 S Main St, Carl Junction, MO 64834 | 2006-05-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407372683 | Stephanie Lynn Forth | Case Manager/Care Coordinator | 6625 County Lane 276, Carl Junction, MO 64834 | 2017-08-18 |
| 1245514959 | John E. Goff, Md PC | Preferred Provider Organization | 104 S Main, Carl Junction, MO 64834 | 2011-09-30 |
| 1194051433 | Tiffany Ann Huffman | Nurse Practitioner | 104 S. Main, Carl Junction, MO 64834 | 2009-10-21 |
| 1215074505 | Harold Robert Bell | Chiropractor | 702 East Pennell Street, Carl Junction, MO 64834-0002 | 2007-01-30 |
| 1114093911 | Stephen W Helman | Dentist | 615 Pennell, Carl Junction, MO 64834-0894 | 2006-11-27 |
| 1710428453 | Ginny Henegar | Doula | 10149 County Road 260, Carl Junction, MO 64834-5162 | 2017-03-14 |
| 1831652049 | Kristin S Turner | Nurse Anesthetist, Certified Registered | 8991 State Highway 171, Carl Junction, MO 64834-6148 | 2019-04-14 |
| 1275517161 | South West Missouri Handycap, Inc. | Durable Medical Equipment & Medical Supplies | 29074 Impatiens Ln, Carl Junction, MO 64834-8141 | 2005-12-04 |
| 1033116520 | Community Residence, Inc. | Custodial Care Facility | 201 Fir Rd, Carl Junction, MO 64834-9222 | 2005-06-30 |
| 1831798453 | Speaklife Therapy Services, LLC | Occupational Therapist | 919 Dogwood Trail Loop, Carl Junction, MO 64834-9309 | 2020-10-24 |
| Find all providers in zip 64834 | ||||
| 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 |
|---|---|---|---|---|
| 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 | ||||
| City | CARL JUNCTION |
| Zip Code | 64834 |
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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.