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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