Organization
POPLAR BLUFF PHARMACY LLC
Active
Other names
John's Pharmacy Poplar Bluff
Organization subpart
No
Provider details
NPI number
Authorized official
ABRAHAM FUNK (OWNER)
(573) 785-0984
Entity
Organization
Contact information
Practice address
909 W PINE ST, POPLAR BLUFF, MO 63901-4958
(573) 785-0984
(573) 785-2257
Mailing address
2007 INDEPENDENCE ST, CAPE GIRARDEAU, MO 63703-5805
(573) 785-0984
(573) 785-2257
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
2016042382
MO
3336C0004X
Compounding Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2166615
PK
—
05
—
600059703
—
MO
Enumeration date
10/18/2016
Last updated
09/19/2025
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