Organization
PLATZ ENTERPRISES INC.
Active
Organization
PLATZ ENTERPRISES INC.
Active
Other names
LTC Hometown Pharmacy, Hometown Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
JILLIAN GARRISON CPHT (OPERATIONS SPECIALIST, LICENSING/CO)
(573) 885-0885
Entity
Organization
Contact information
Practice address
1409 N JEFFERSON ST, CARROLLTON, MO 64633-1945
(660) 542-2020
(660) 542-2025
Mailing address
PO BOX 528, CUBA, MO 65453-0528
(573) 885-0885
(573) 677-0567
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
002190
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2162061
PK
—
05
—
600122303
—
MO
Enumeration date
07/20/2016
Last updated
08/08/2023
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