Organization
HINES STREET PHARMACY LLC
Active
Other names
Hines Street Pharmacy LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STEPHEN L MCCLANAHAN II RPH. (OWNER)
(417) 735-0055
Entity
Organization
Contact information
Practice address
1173 E HINES ST, REPUBLIC, MO 65738-1277
(417) 735-0055
(417) 732-1529
Mailing address
1173 E HINES ST, REPUBLIC, MO 65738-1277
(417) 735-0055
(417) 732-1529
Taxonomy
Speciality
Code
Description
License number
State
163WD0400X
Diabetes Educator Registered Nurse
—
—
3336C0003X
Community/Retail Pharmacy
Primary
2012001548
MO
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2133471
PK
—
05
—
609551700
—
MO
Enumeration date
12/20/2011
Last updated
11/24/2020
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up