Organization
FAMILY PHARMACY OF MISSOURI LLC
Active
Other names
FAMILY PHARMACY #20
Organization subpart
No
Provider details
NPI number
Authorized official
LYNN MORRIS RPH MS (PRESIDENT)
(417) 581-4335
Entity
Organization
Contact information
Practice address
1326 W BROADWAY ST, BOLIVAR, MO 65613-1815
(417) 326-8747
(417) 326-8748
Mailing address
1326 W BROADWAY ST, BOLIVAR, MO 65613-1815
(417) 326-8747
(417) 326-8748
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
2006014908
MO
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2636934
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
606261105
—
MO
Enumeration date
09/21/2006
Last updated
03/14/2012
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