Active NPI
Platz Enterprises Inc.
Doing business as Hometown Pharmacy
- Community/Retail Pharmacy
- Carrollton, MO
National Provider Identifier
1275627127
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- 002190
- Legal business name
- PLATZ ENTERPRISES INC.
- Doing business as
- Hometown Pharmacy
- Practice address
- 1409 N Jefferson St
Carrollton, MO 64633-1945 - Phone
- (660) 542-2020
- Fax
- (660) 542-2025
- NPI assigned
- Oct 3, 2006
- Last updated
- Jul 25, 2023
- Organization subpart
- Yes
- Parent organization
- PLATZ ENTERPRISES INC.
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Amy Mitchell
- Title
- President
- Phone
- (573) 885-0885
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | 002190 | MO | Primary |
| Long Term Care Pharmacy | 3336L0003X |
Addresses
Primary practice location
1409 N Jefferson St
Carrollton, MO 64633-1945
Mailing address
330 N. Franklin
PO Box 528
Cuba, MO 65453
Phone (573) 885-0885
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 600122303 | Medicaid | MO | |
| 2048784 | Other | PK |
Other names 1
- Hometown Pharmacy
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20091001000524 | MO | Part B Supplier - Mass Immunization (Roster Biller Only) | 7719023951 | Practice locations: Carrollton, MO |
| O20100930079744 | MO | DME Supplier - Pharmacy | 7719023951 | Practice locations: Carrollton, MO |
National Provider Directory
National Provider Directory- Tax ID family
- Main Drugs
- Part of
- Main Drugs
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
Member of 1
Organizations this organization is a member of, according to the National Provider Directory.
-
dba Sinks Pharmacy
- Community/Retail Pharmacy
- Vienna, MO
- NPI 1538158274
Member Of
Ownership & related parties
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.
Practitioners & affiliated clinicians
Practitioners 3
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
- Moberly, MO
- NPI 1780060855
-
- Pharmacist
- Carrollton, MO
- NPI 1437921467
-
- Pharmacist
- Carrollton, MO
- NPI 1447426861
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159833600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1690243200000",
"number": "1275627127",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "330 N. FRANKLIN",
"address_2": "PO BOX 528",
"city": "CUBA",
"state": "MO",
"postal_code": "65453",
"telephone_number": "573-885-0885",
"fax_number": "573-677-0567"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1409 N JEFFERSON ST",
"city": "CARROLLTON",
"state": "MO",
"postal_code": "646331945",
"telephone_number": "660-542-2020",
"fax_number": "660-542-2025"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PLATZ ENTERPRISES INC.",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "PLATZ ENTERPRISES INC.",
"enumeration_date": "2006-10-03",
"last_updated": "2023-07-25",
"certification_date": "2023-07-25",
"status": "A",
"authorized_official_last_name": "MITCHELL",
"authorized_official_first_name": "AMY",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "573-885-0885",
"authorized_official_name_prefix": "Mrs."
},
"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": "002190",
"primary": true
},
{
"code": "3336L0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Long Term Care Pharmacy",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "600122303",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PK",
"identifier": "2048784",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Hometown Pharmacy",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Carrollton, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2023; 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.