Sikeston Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

2015019988 Issued in MO

Legal business name

SIKESTON PHARMACY LLC

Practice address

507 N Main St
Sikeston, MO 63801-2105

Phone

(573) 471-4401

Fax

(573) 471-5448

NPI assigned

Nov 15, 2006

Organization subpart

No

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

Authorized official

Name

Donald Schreiber

Title

President

Phone

(314) 965-4700

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Sikeston Medicenter Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in MO3 enrollments

Enrollment records 3

Tax ID family

Script Masters Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Sikeston Pharmacy LLC

  • Long Term Care Pharmacy
  • Sikeston, MO
  • NPI 1316614001
  NPD tax ID

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jennifer Elizabeth Baker, PHARM.D.

  • Pharmacist
  • Sikeston, MO
  • NPI 1821614090
  NPD (past)
• Ronnie Wade Hamra, RPH

  • Pharmacist
  • Sikeston, MO
  • NPI 1063681229
  NPD (past)

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611360000000",
    "number": "1194897983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "507 N MAIN ST",
            "city": "SIKESTON",
            "state": "MO",
            "postal_code": "638012105",
            "telephone_number": "573-471-4401",
            "fax_number": "573-471-5448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "507 N MAIN ST",
            "city": "SIKESTON",
            "state": "MO",
            "postal_code": "638012105",
            "telephone_number": "573-471-4401",
            "fax_number": "573-471-5448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIKESTON PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-15",
        "last_updated": "2021-01-23",
        "certification_date": "2021-01-23",
        "status": "A",
        "authorized_official_last_name": "SCHREIBER",
        "authorized_official_first_name": "DONALD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "314-965-4700"
    },
    "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": "2015019988",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2152744",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sikeston Medicenter Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Emily Michelle Shor, PHARMD
• Sikeston Emergency Group LLC
• Sikeston Health Care for All LLC
• Sikeston Imaging Center, LLC
• Sikeston Medical Center, L.L.P
• Sikeston Pharmacy LLC
• Sikeston R6 School District
• Sikeston Rehab, LLC
• Sikeston Rural Health Center LLC
• Sikeston Surgical Specialist, LLC

• Community/Retail Pharmacy in Sikeston, MO
• Providers in Sikeston, 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 Jan 23, 2021; 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.

Verify at the official NPI Registry.