Levi Keith Hare-Townsend
Individual provider Active NPI Pharmacist · Republic, MO
NPI 1154935922 · NPPES record last updated Aug 31, 2020
Key facts
- NPI
- 1154935922
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 2018025575 (MO)
- Practice address
- 1050 US Highway 60 E
Republic, MO 65738-1569 - Phone
- (417) 732-8246
- NPI assigned
- Aug 31, 2020
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2018025575 | MO | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past |
Accepting new patients | |
| Walgreen Co | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 2018025575 | MO | Yes |
Addresses
Primary practice location
1050 US Highway 60 E
Republic, MO 65738-1569
Mailing address
1050 US Highway 60 E
Republic, MO 65738-1569
Phone (417) 732-8246
Other providers in Republic, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 31, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.