Mitchell'S Drug Store On The Boulevard
LBN: Tim Mitchell Medical, Inc
Mitchell'S Drug Store On The Boulevard is an health care organization with primary practice located at 719 S Neosho Blvd Ste A, Neosho MO 64850. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Durable Medical Equipment & Medical Supplies, Suppliers / Community/Retail Pharmacy, Suppliers / Compounding Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty.
Tim Mitchell Medical, Inc can be contacted via phone (417) 451-9501, or through Mitchell, Tim via phone (417) 451-9501.
Contact Information
Primary practice address
719 S Neosho Blvd Ste A
Neosho MO 64850
Phone: (417) 451-9501
Fax: (417) 451-9594
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Suppliers / Durable Medical Equipment & Medical Supplies | 332B00000X | ||
| Suppliers / Community/Retail Pharmacy | 3336C0003X | 2003027740 | Missouri |
| Suppliers / Compounding Pharmacy | 3336C0004X |
Profile Details
| NPI number | 1578669701 |
|---|---|
| LBN Legal business name | Tim Mitchell Medical, Inc |
| DBA Doing business as | Mitchell'S Drug Store On The Boulevard |
| Authorized official | Mitchell, Tim R.PH. |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Sep 15th, 2006 |
| Last updated | Dec 6th, 2021 - about 4 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1578669701 | NPPES |
| Kansas | MEDICAID | 200642940A | |
| Kansas | MEDICAID | 200286710A | |
| Kansas | MEDICAID | 602932303 | |
| Kansas | MEDICAID | 622932309 |
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