Northwest Pharmacy, Inc

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

620059725 Issued in MO

Legal business name

NORTHWEST PHARMACY, INC

Practice address

2210 Barron Rd
Poplar Bluff, MO 63901-1908

Phone

(573) 686-6211

Fax

(573) 686-2219

NPI assigned

Mar 15, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Mark T Kleinbeck, RPH

Title

President

Phone

(573) 686-6211

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1245364066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2210 BARRON RD",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639011908",
            "telephone_number": "573-686-6211",
            "fax_number": "573-686-2219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2210 BARRON RD",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639011908",
            "telephone_number": "573-686-6211",
            "fax_number": "573-686-2219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST PHARMACY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-15",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "KLEINBECK",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "573-686-6211",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "MO",
            "license": "620059725",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "620059725",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RX NPI",
            "identifier": "1902974140",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MO PHARMACY PERMIT",
            "identifier": "2004019998",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lynda C Nobles
• Grace Norberry
• Norman H Buchman & Assoc PC
• Northwest Medical Osteoporosis Center LLC
• Northwest Pharmacy Inc
• Nova Radiology Consultants, LLC
• Jennifer B. Nowak, M.S., CCC-SLP
• Kaci O'Neill, MSN
• Oak Meadows RCF LLC
• David Carroll Odom, RPH

• Durable Medical Equipment & Medical Supplies in Poplar Bluff, MO
• Providers in Poplar Bluff, MO by specialty
• Durable Medical Equipment & Medical Supplies in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.