Organization
MADISON MEDICAL CENTER
Active
Other names
MADISON MEDICAL CENTER PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
LINDA HATCH RPH (PHARMACY DIRECTOR)
(573) 783-1047
Entity
Organization
Contact information
Practice address
611 W MAIN ST, FREDERICKTOWN, MO 63645-1111
(573) 783-1047
(573) 783-1063
Mailing address
611 W MAIN ST, PO BOX 431, FREDERICKTOWN, MO 63645-1111
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
—
—
3336I0012X
Institutional Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
003980
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010155109
—
MO
01
—
2050238
PK
—
05
—
601458003
—
MO
Enumeration date
01/18/2007
Last updated
10/10/2016
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