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Organization

GILLEN PHARMACY INC

Active
Other names
Gillen Pharmacy
Organization subpart
No

Provider details

NPI number
Authorized official
LEANNE DICKERSON DPH (OWNER)
(816) 884-4559
Entity
Organization

Contact information

Practice address
2820 E ROCK HAVEN RD STE 110, HARRISONVILLE, MO 64701-4413
(816) 884-5115
(816) 884-4559
Mailing address
2820 E ROCK HAVEN RD STE 110, HARRISONVILLE, MO 64701-4413
(816) 884-5115
(816) 884-4559

Taxonomy

Speciality
Code
Description
License number
State
333600000X
Pharmacy
3336C0003X
Community/Retail Pharmacy
Primary
2002016484
MO
3336L0003X
Long Term Care Pharmacy

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2048908
PK
05
600309702
MO
Enumeration date
01/25/2006
Last updated
09/19/2025
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