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Organization
FAMILY PHARMACY OF MISSOURI LLC
Active
Organization
FAMILY PHARMACY OF MISSOURI LLC
Active
Other names
Family Pharmacy #16
Organization subpart
No
Provider details
NPI number
Authorized official
LYNN A MORRIS R.PH. (PRESIDENT)
(417) 759-6300
Entity
Organization
Contact information
Practice address
49 E OLD MILL RD, FAIR GROVE, MO 65648-8452
(417) 759-6300
(417) 759-6305
Mailing address
PO BOX 244, FAIR GROVE, MO 65648-0244
(417) 759-6300
(417) 759-6305
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
2004031235
MO
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2635766
NCPDP
MO
05
—
606166601
—
MO
01
—
626166607
MEDICAID DME
MO
05
—
626166607
—
MO
Enumeration date
02/20/2006
Last updated
04/06/2017
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