Organization
MARSHFIELD CLINIC PHARMACY LLC
Active
Other names
MARSHFIELD CLINIC PHARMACY LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL VINEHOUT RPH (MANAGING MEMBER)
(417) 468-4442
Entity
Organization
Contact information
Practice address
483 POMME DE TERRE, MARSHFIELD, MO 65706-2386
(417) 468-4442
(417) 468-4462
Mailing address
483 POMME DE TERRE, MARSHFIELD, MO 65706-2386
(417) 468-4442
(417) 468-4462
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
2004036065
MO
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2629117
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
606937902
—
MO
05
—
626937908
—
MO
Enumeration date
08/18/2006
Last updated
06/11/2021
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