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Organization

HINES STREET PHARMACY LLC

Active
Parent organization
HINES STREET PHARMACY LLC
Organization subpart
Yes

Provider details

NPI number
Legal business name
HINES STREET PHARMACY LLC
Authorized official
STEPHEN L MCCLANAHAN (OWNER)
(417) 735-0055
Entity
Organization

Contact information

Practice address
1173 E HINES ST, REPUBLIC, MO 65738-1277
(417) 735-0055
Mailing address
1173 E HINES ST, REPUBLIC, MO 65738-1277
(417) 735-0055

Taxonomy

Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary

Other

Enumeration date
07/14/2023
Last updated
07/14/2023
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