Organization
SCOTLAND COUNTY PHARMACY INC
Active
Other names
Scotland County Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MATT W MCKEE R.PH. (PHARMACIST)
(660) 465-2400
Entity
Organization
Contact information
Practice address
445 GRAND AVE, MEMPHIS, MO 63555-1501
(660) 465-2400
(660) 465-2600
Mailing address
445 EAST GRAND AVE, MEMPHIS, MO 63555
(660) 465-2400
(660) 465-2600
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
6321930001
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
2004020933
MO
3336C0004X
Compounding Pharmacy
2004028311
MO
3336L0003X
Long Term Care Pharmacy
2004020933
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
606141901
—
MO
01
—
626141907
MISSOURI MEDICAID DME NUMBER
MO
Enumeration date
06/17/2006
Last updated
08/17/2021
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