Main Street Pharmacy

LBN: Main Street Pharmacy Llc
Main Street Pharmacy 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 / Community/Retail Pharmacy, 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 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
Phone: (573) 649-9229

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Community/Retail Pharmacy 3336C0003X 2013000674 Missouri

Profile Details

NPI number 1689700379
LBN Legal business name Main Street Pharmacy Llc
DBA Doing business as Main Street Pharmacy
Authorized official Johnson, Tera
Entity Organization
Organization subpart 1 No
Enumeration date Feb 26th, 2007
Last updated Feb 9th, 2015 - about 9 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1689700379 NPPES
Other 2048743 PK
MEDICAID 605420405 PK

Popular Providers