Organization
PHARMAX INC.
Active
Other names
dba Pharmax Pharmacy #1302
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LARRY T MCINTOSH (PRESIDENT)
(314) 954-5510
Entity
Organization
Contact information
Practice address
610 E HIGH ST, POTOSI, MO 63664-1406
(573) 438-2189
Mailing address
610 E HIGH ST, POTOSI, MO 63664-1406
(573) 438-2189
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PS005653
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2616374
NCPDP #
MO
05
—
600399208
—
MO
01
—
620399204
MEDICAID DME
MO
Enumeration date
08/31/2006
Last updated
03/07/2023
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