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Organization
FAMILY PHARMACY OF MISSOURI LLC
Active
Organization
FAMILY PHARMACY OF MISSOURI LLC
Active
Other names
Family Pharmacy #14
Organization subpart
No
Provider details
NPI number
Authorized official
LYNN A MORRIS R.PH. (OWNER/PRESIDENT)
(417) 581-4335
Entity
Organization
Contact information
Practice address
105 S RIDGECREST AVE, SUITE 1 & 2, NIXA, MO 65714-7807
(417) 724-2601
(417) 724-2621
Mailing address
PO BOX 1440, NIXA, MO 65714-1440
(417) 724-2601
(417) 724-2621
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
2004026659
MO
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2635677
NCPDP
MO
05
—
606155802
—
MO
01
—
626155808
MEDICAID DME
MO
05
—
626155808
—
MO
Enumeration date
02/22/2006
Last updated
04/06/2017
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