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Organization

MEDKIN PHARMACY LLC

Active
Parent organization
MEDKIN PHARMACY LLC
Other names
Medicine Cabinet Pharmacy
Organization subpart
Yes

Provider details

NPI number
Legal business name
MEDKIN PHARMACY LLC
Authorized official
MR. JOHN WAYNE HEWKIN RPH. (MEMBER/OWNER/PHARMACIST)
(573) 308-5033
Entity
Organization

Contact information

Practice address
105 PROGRESS PKWY, SULLIVAN, MO 63080-2359
(573) 860-3600
(573) 860-2636
Mailing address
105 PROGRESS PKWY, MEDICINE CABINET PHARMACY, SULLIVAN, MO 63080-2359
(573) 860-3600
(573) 860-2636

Taxonomy

Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
5100
MO
3336C0003X
Community/Retail Pharmacy
2003001706
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
5100
MO BOARD OF PHARMA
MO
05
6060000701
MO
05
626000707
MO
Enumeration date
07/09/2006
Last updated
11/16/2009
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