Organization
FAMILY PHARMACY OF MISSOURI LLC
Active
Other names
FAMILY PHARMACY #26
Organization subpart
No
Provider details
NPI number
Authorized official
LYNN MORRIS (PRESIDENT/OWNER)
(417) 581-4335
Entity
Organization
Contact information
Practice address
225 CROSS CREEK BLVD STE A, BRANSON, MO 65616-7520
(417) 334-5069
(417) 334-5079
Mailing address
PO BOX 507, HOLLISTER, MO 65673-0507
(417) 334-5069
(417) 334-5079
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
3336L0003X
Long Term Care Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1528362480
—
MO
01
—
2639562
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
01/06/2011
Last updated
01/24/2014
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