Organization
FAMILY PHARMACY INC
Active
Other names
FAMILY PHARMACY #23
Organization subpart
No
Provider details
NPI number
Authorized official
CARRIE TENNIS (DIR OF OPER)
(417) 581-4335
Entity
Organization
Contact information
Practice address
527 W KEARNEY ST, SPRINGFIELD, MO 65803-2523
(417) 869-2988
(417) 869-6826
Mailing address
PO BOX 949, OZARK, MO 65721-0949
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
2007032455
MO
3336C0004X
Compounding Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2637671
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
606348764
—
MO
Enumeration date
10/04/2007
Last updated
03/31/2014
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