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Organization

QUEEN CITY PHARMACIES, LLC

Active
Other names
Medicenter Pharmacy
Organization subpart
No

Provider details

NPI number
Authorized official
REBEKAH ANN ROSE (OPERATIONS MANAGER)
(417) 881-8841
Entity
Organization

Contact information

Practice address
1474 N BOONVILLE AVE, SPRINGFIELD, MO 65802-1806
(417) 869-1866
(417) 869-6601
Mailing address
1474 N BOONVILLE AVE, SPRINGFIELD, MO 65802-1806
(417) 869-1866
(417) 869-6601

Taxonomy

Speciality
Code
Description
License number
State
333600000X
Pharmacy
3336C0003X
Community/Retail Pharmacy
006537
MO
3336C0003X
Community/Retail Pharmacy
Primary
2017031169
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2603810
NCPDP PROVIDER IDENTIFICATION NUMBER
05
600051320
MO
Enumeration date
11/15/2006
Last updated
05/01/2019
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