Organization
OLD TOWN PHARMACY NUMBER 2 LLC
Active
Other names
Old Town Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
SHANE BECKER (OWNER)
(417) 476-2828
Entity
Organization
Contact information
Practice address
119 E MAIN ST, PIERCE CITY, MO 65723-1228
(417) 476-2828
(417) 476-5198
Mailing address
119 E MAIN ST, PIERCE CITY, MO 65723-1228
(417) 476-2828
(417) 476-5198
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
2016027850
MO
3336C0003X
Community/Retail Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2162359
PK
—
Enumeration date
08/10/2016
Last updated
08/31/2016
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us