Organization
ALLIANT LTC PHARMACY LLC
Active
Organization
ALLIANT LTC PHARMACY LLC
Active
Other names
Alliant LTC, John's Rx Southwest LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MARK MCMULLIN (OWNER)
(573) 290-2332
Entity
Organization
Contact information
Practice address
5497 N 17TH ST, OZARK, MO 65721-7663
(417) 485-6200
(417) 485-6201
Mailing address
2007 INDEPENDENCE ST, CAPE GIRARDEAU, MO 63703-5805
(573) 334-5125
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
—
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1306324173
—
MO
Enumeration date
08/02/2018
Last updated
10/13/2021
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