# HINES STREET PHARMACY 2 LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** HINES STREET PHARMACY 2 LLC
- **Other names:** Marionville Health Services
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1255171039
- **Legal business name:** HINES STREET PHARMACY 2 LLC
- **Authorized official:** STEPHEN L MCCLANAHAN (OWNER)
- **Authorized official phone:** (417) 735-0055

## Contact information

- **Practice address:** 201 S HIGHWAY 60, MARIONVILLE, MO 65705-9407
- **Practice address phone:** (417) 735-0055
- **Mailing address:** 1173 E HINES ST, REPUBLIC, MO 65738-1277

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 05/29/2024
- **Last updated:** 05/29/2024