Organization
CGI PHARMACY LLC
Active
Other names
Heartland Family Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
ABRAHAM T FUNK (OWNER)
(573) 334-1300
Entity
Organization
Contact information
Practice address
1020 N KINGSHIGHWAY ST STE A, CAPE GIRARDEAU, MO 63701-3500
(573) 335-1002
(573) 335-8259
Mailing address
2001 INDEPENDENCE ST, CAPE GIRARDEAU, MO 63703-5805
(573) 335-1002
(573) 335-8259
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
602663106
—
MO
Enumeration date
06/08/2016
Last updated
02/18/2022
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