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Organization

HINES STREET PHARMACY 2 LLC

Active
Parent organization
HINES STREET PHARMACY 2 LLC
Other names
Marionville Health Services
Organization subpart
Yes

Provider details

NPI number
Legal business name
HINES STREET PHARMACY 2 LLC
Authorized official
STEPHEN L MCCLANAHAN (OWNER)
(417) 735-0055
Entity
Organization

Contact information

Practice address
201 S HIGHWAY 60, MARIONVILLE, MO 65705-9407
(417) 735-0055
Mailing address
1173 E HINES ST, REPUBLIC, MO 65738-1277

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary

Other

Enumeration date
05/29/2024
Last updated
05/29/2024
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