# CARTHAGE PHARMACY SERVICES INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Hometown Pharmacy \#4
- **Organization subpart:** No

## Provider details

- **NPI number:** 1063513398
- **Authorized official:** CHARLES DAVIN VAUGHN RPH (PRESIDENT/OWNER)
- **Authorized official phone:** (417) 461-7777

## Contact information

- **Practice address:** 606 E MOUNT VERNON BLVD, MOUNT VERNON, MO 65712-9100
- **Practice address phone:** (417) 466-2000
- **Practice address fax:** (417) 466-2028
- **Mailing address:** PO BOX 68, MOUNT VERNON, MO 65712-0068
- **Mailing address phone:** (417) 466-2000
- **Mailing address fax:** (417) 466-2028

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | 2004011847 | MO | Yes |

## Other

- **Enumeration date:** 09/26/2006
- **Last updated:** 11/14/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 601917503 | — | MO |