Family Pharmacy of Missouri LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

2006014908 Issued in MO

Legal business name

FAMILY PHARMACY OF MISSOURI LLC

Doing business as

Family Pharmacy #20

Practice address

1326 W Broadway St
Bolivar, MO 65613-1815

Phone

(417) 326-8747

Fax

(417) 326-8748

NPI assigned

Sep 21, 2006

Last updated

Mar 14, 2012By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Lynn Morris, RPH MS

Title

President

Phone

(417) 581-4335

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• FAMILY PHARMACY #20 Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1331683200000",
    "number": "1033217062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1326 W BROADWAY ST",
            "city": "BOLIVAR",
            "state": "MO",
            "postal_code": "656131815",
            "telephone_number": "417-326-8747",
            "fax_number": "417-326-8748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1326 W BROADWAY ST",
            "city": "BOLIVAR",
            "state": "MO",
            "postal_code": "656131815",
            "telephone_number": "417-326-8747",
            "fax_number": "417-326-8748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY PHARMACY OF MISSOURI LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-21",
        "last_updated": "2012-03-14",
        "status": "A",
        "authorized_official_last_name": "MORRIS",
        "authorized_official_first_name": "LYNN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "417-581-4335",
        "authorized_official_credential": "RPH MS"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MO",
            "license": "2006014908",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "2636934",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "606261105",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FAMILY PHARMACY #20",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Bolivar, MO
• Providers in Bolivar, MO by specialty
• Community/Retail Pharmacy in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.