Hines Street Pharmacy 2 LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

HINES STREET PHARMACY 2 LLC

Doing business as

Marionville Health Services

Practice address

201 S Highway 60
Marionville, MO 65705-9407

Phone

(417) 735-0055

NPI assigned

May 29, 2024

Last updated

May 29, 2024By the provider in NPPES

Organization subpart

Yes

Parent organization

HINES STREET PHARMACY 2 LLCAs reported in NPPES

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

Authorized official

Name

Stephen L McClanahanNPI 1487275707

Title

Owner

Phone

(417) 735-0055

Specialties & licenses 1

Addresses

Other names 1

• Marionville Health Services Doing business as

Tax ID family

Hines Street Pharmacy 2 LLC2 organizations share this tax ID, including this one

Part of

Hines Street Pharmacy 2 LLC

Other organizations with this tax ID 1

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

• Hines Street Pharmacy 2 LLC

  • Family Medicine Physician
  • Battlefield, MO
  • NPI 1982451613
  NPD tax ID

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Hines Street Pharmacy 2 LLC

  • Family Medicine Physician
  • Republic, MO
  • NPI 1790439842
  NPPES parent name

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.

• Stephen L McClanahan II, RPH.

  • Pharmacist
  • Republic, MO
  • NPI 1487275707
  Authorized official Same address or phone

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

{
    "created_epoch": "1716940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716940800000",
    "number": "1255171039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1173 E HINES ST",
            "city": "REPUBLIC",
            "state": "MO",
            "postal_code": "657381277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 S HIGHWAY 60",
            "city": "MARIONVILLE",
            "state": "MO",
            "postal_code": "657059407",
            "telephone_number": "417-735-0055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HINES STREET PHARMACY 2 LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HINES STREET PHARMACY 2 LLC",
        "enumeration_date": "2024-05-29",
        "last_updated": "2024-05-29",
        "certification_date": "2024-05-29",
        "status": "A",
        "authorized_official_last_name": "MCCLANAHAN",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "417-735-0055"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Marionville Health Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kathleen Marie Blumenthal, PHARM D
• Natalie Elaine Clark
• Sarah Geltmacher, NP
• Rebecca Grace Mae White Henbest
• Emily Erin Hood, MS CCC SLP
• Gail Irwin, EAL
• David William Kuzemka, SLP
• Marionville Pharmacy LLC
• Marionville Pharmacy LLC

• Family Medicine Physician in Marionville, MO
• Providers in Marionville, MO by specialty
• Family Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2024; 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.