# MEDKIN PHARMACY LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** MEDKIN PHARMACY LLC
- **Other names:** Medicine Cabinet Pharmacy
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1003849316
- **Legal business name:** MEDKIN PHARMACY LLC
- **Authorized official:** MR. JOHN WAYNE HEWKIN RPH. (MEMBER/OWNER/PHARMACIST)
- **Authorized official phone:** (573) 308-5033

## Contact information

- **Practice address:** 105 PROGRESS PKWY, SULLIVAN, MO 63080-2359
- **Practice address phone:** (573) 860-3600
- **Practice address fax:** (573) 860-2636
- **Mailing address:** 105 PROGRESS PKWY, MEDICINE CABINET PHARMACY, SULLIVAN, MO 63080-2359
- **Mailing address phone:** (573) 860-3600
- **Mailing address fax:** (573) 860-2636

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | 5100 | MO | Yes |
| 3336C0003X | Community/Retail Pharmacy | 2003001706 | MO | — |

## Other

- **Enumeration date:** 07/09/2006
- **Last updated:** 11/16/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 5100 | MO BOARD OF PHARMA | MO |
| 05 | — | 6060000701 | — | MO |
| 05 | — | 626000707 | — | MO |