Active NPI
Parkland Apothecary LLC
Doing business as Parkland Pharmacy
- Community/Retail Pharmacy
- Desloge, MO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- 2005028538
- Legal business name
- PARKLAND APOTHECARY LLC
- Doing business as
- Parkland Pharmacy
- Practice address
- 1131 N Desloge Dr
Desloge, MO 63601-2936 - Phone
- (573) 431-6677
- Fax
- (573) 431-3833
- NPI assigned
- Oct 24, 2005
- Last updated
- Jan 25, 2025
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Lisa Umfleet, RPH
- Title
- President
- Phone
- (573) 431-6677
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | 2005028538 | MO | Primary |
| Specialty Pharmacy | 3336S0011X | |||
| Compounding Pharmacy | 3336C0004X |
Addresses
Primary practice location
1131 N Desloge Dr
Desloge, MO 63601-2936
Mailing address
1131 N Desloge Dr
Desloge, MO 63601-2936
Phone (573) 431-6677
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2049127 | Other | PK | |
| 606222008 | Medicaid | MO |
Other names 1
- Parkland Pharmacy
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
Enrollment records 3
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100930092312 | MO | DME Supplier - Pharmacy | 7214138015 | Practice locations: Desloge, MO |
| O20121117000020 | MO | Part B Supplier - Mass Immunization (Roster Biller Only) | 7214138015 | Practice locations: Desloge, MO |
| O20130816000775 | MO | Part B Supplier - Pharmacy | 7214138015 | Practice locations: Desloge, MO |
National Provider Directory
National Provider DirectoryLocations
1131 N Desloge Dr
Desloge, MO 63601
Phone (573) 431-6677
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Pharmacist
- Desloge, MO
- NPI 1528168689
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1130112000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1737763200000",
"number": "1114917903",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1131 N DESLOGE DR",
"city": "DESLOGE",
"state": "MO",
"postal_code": "636012936",
"telephone_number": "573-431-6677",
"fax_number": "573-431-3833"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1131 N DESLOGE DR",
"city": "DESLOGE",
"state": "MO",
"postal_code": "636012936",
"telephone_number": "573-431-6677",
"fax_number": "573-431-3833"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PARKLAND APOTHECARY LLC",
"organizational_subpart": "NO",
"enumeration_date": "2005-10-24",
"last_updated": "2025-01-25",
"certification_date": "2025-01-25",
"status": "A",
"authorized_official_last_name": "UMFLEET",
"authorized_official_first_name": "LISA",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "573-431-6677",
"authorized_official_credential": "RPH"
},
"taxonomies": [
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": null,
"license": null,
"primary": false
},
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": null,
"license": null,
"primary": false
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "MO",
"license": "2005028538",
"primary": true
},
{
"code": "3336S0011X",
"taxonomy_group": "",
"desc": "Pharmacy, Specialty Pharmacy",
"state": null,
"license": null,
"primary": false
},
{
"code": "3336C0004X",
"taxonomy_group": "",
"desc": "Pharmacy, Compounding Pharmacy",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PK",
"identifier": "2049127",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "606222008",
"state": "MO"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Parkland Pharmacy",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Desloge, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.