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Organization
PUXICO PHARMACY, LLC
Active
Organization
PUXICO PHARMACY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ABRAHAM FUNK PHARMD (PRESIDENT/OWNER)
(573) 222-6206
Entity
Organization
Contact information
Practice address
190 E. RICHARDSON AVE, PUXICO, MO 63960
(573) 222-6206
(573) 222-6406
Mailing address
2001 INDEPENDENCE ST, CAPE GIRARDEAU, MO 63703-5805
(573) 222-6206
(573) 222-6406
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
042607
MO
3336L0003X
Long Term Care Pharmacy
—
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
600-096-507
—
MO
05
—
620096503
—
MO
Enumeration date
10/25/2006
Last updated
04/27/2022
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