Bolivar Drug

LBN: Sparks Pharmacy Inc
Bolivar Drug is an health care organization with primary practice located at 1001 E Cambridge St , Bolivar MO 65613-3502. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Sparks Pharmacy Inc can be contacted via phone (417) 326-7455, or through Summers, Ryan via phone (417) 326-7455.

Contact Information

Primary practice address
1001 E Cambridge St Bolivar MO 65613-3502
Phone: (417) 326-7455
Fax: (417) 326-7757
Website:
Map and Directions
Authorized official contact:
Name: Summers, Ryan
Phone: (417) 326-7455

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X 005482 Missouri

Profile Details

NPI number 1801809785
LBN Legal business name Sparks Pharmacy Inc
DBA Doing business as Bolivar Drug
Authorized official Summers, Ryan
Entity Organization
Organization subpart 1 No
Enumeration date Aug 14th, 2006
Last updated Jan 21st, 2016 - about 8 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 1801809785 NPPES
Other 2051548 PK
MEDICAID 602599607 PK
MEDICAID 622599603 PK

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