The Medicine Shoppe Pharmacy

LBN: Pevely Rx
The Medicine Shoppe Pharmacy is an health care organization with primary practice located at 8640 Commercial Blvd , Pevely MO 63070-1529. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Community/Retail Pharmacy, Suppliers / Compounding Pharmacy, Suppliers / Long Term Care Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Pevely Rx can be contacted via phone (636) 479-6100, or through Wang, Jason Alexander via phone (314) 753-8851.

Contact Information

Primary practice address
8640 Commercial Blvd Pevely MO 63070-1529
Phone: (636) 479-6100
Fax: (636) 479-6101
Website:
Map and Directions
Authorized official contact:
Name: Wang, Jason Alexander PHARMD
Phone: (314) 753-8851

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Community/Retail Pharmacy 3336C0003X 2012030942 Missouri
Suppliers / Compounding Pharmacy 3336C0004X
Suppliers / Long Term Care Pharmacy 3336L0003X

Profile Details

NPI number 1790034064
LBN Legal business name Pevely Rx
DBA Doing business as The Medicine Shoppe Pharmacy
Authorized official Wang, Jason Alexander PHARMD
Entity Organization
Organization subpart 1 No
Enumeration date Sep 2nd, 2012
Last updated Jun 10th, 2024 - about last year

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 1790034064 NPPES
Other 2136810 PK
MEDICAID 606585404 PK

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