Organization
FAMILY PHARMACY OF MISSOURI LLC
Active
Other names
Family Pharmacy #12
Organization subpart
No
Provider details
NPI number
Authorized official
LYNN A MORRIS (OWNER/PRESIDENT)
(417) 581-4335
Entity
Organization
Contact information
Practice address
14974 STATE HWY 160, FORSYTH, MO 65653
(417) 546-8200
(417) 546-8207
Mailing address
PO BOX 1175, FORSYTH, MO 65653-1175
(417) 546-8200
(417) 546-8207
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
2004008738
MO
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2635475
NCPDP
MO
05
—
606141604
—
MO
01
—
626141600
MEDICAID DME
MO
05
—
626141600
—
MO
Enumeration date
02/22/2006
Last updated
04/06/2017
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