Mercy Pharmacy Broadway
LBN: Southeast Hospital
Mercy Pharmacy Broadway is an health care organization with primary practice located at 1723 Broadway Ste 110 , Cape Girardeau MO 63701. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy, Suppliers / Long Term Care Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty.
Southeast Hospital can be contacted via phone (573) 331-7900, or through Berry, Krista via phone (573) 331-6028.
Contact Information
Primary practice address
1723 Broadway Ste 110
Cape Girardeau MO 63701
Phone: (573) 331-7900
Fax: (573) 331-7909
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Suppliers / Pharmacy | 333600000X | ||
| Suppliers / Community/Retail Pharmacy | 3336C0003X | 006426 | Missouri |
| Suppliers / Long Term Care Pharmacy | 3336L0003X |
Profile Details
| NPI number | 1336150846 |
|---|---|
| LBN Legal business name | Southeast Hospital |
| DBA Doing business as | Mercy Pharmacy Broadway |
| Authorized official | Berry, Krista |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Aug 10th, 2006 |
| Last updated | Jan 13th, 2024 - about 11 months 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1336150846 | NPPES |
| Other | 2631996 | NCPDP PROVIDER IDENTIFICATION NUMBER | |
| MEDICAID | 603829300 | NCPDP PROVIDER IDENTIFICATION NUMBER |
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Southeast Hospital
817 S Mount Auburn Rd Ste 130 , Cape Girardeau MO 63703-6392