Main Street Pharmacy Llc.

LBN: Main Street Pharmacy Llc.
Main Street Pharmacy Llc. is an health care organization with primary practice located at 117 E Main St , East Prairie MO 63845-1136. The organization recently has only one registered license in Suppliers / Durable Medical Equipment & Medical Supplies, which is considered as the primary health care specialty. Main Street Pharmacy Llc. can be contacted via phone (573) 649-9229, or through Johnson, Tera S via phone (573) 649-9229.

Contact Information

Primary practice address
117 E Main St East Prairie MO 63845-1136
Phone: (573) 649-9229
Fax: (573) 649-9230
Website:
Map and Directions
Authorized official contact:
Name: Johnson, Tera S
Phone: (573) 649-9229

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X

Profile Details

NPI number 1316928989
LBN Legal business name Main Street Pharmacy Llc.
DBA Doing business as
Authorized official Johnson, Tera S
Entity Organization
Organization subpart 1 No
Enumeration date Nov 9th, 2005
Last updated Jan 2nd, 2013 - about 11 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1316928989 NPPES
Missouri MEDICAID 625420401

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