Osage Pharmacy, LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

623809308 Issued in MO

Legal business name

OSAGE PHARMACY, LLC

Practice address

513B Grand Ave
Doniphan, MO 63935-1405

Phone

(573) 996-3784

Fax

(573) 996-5275

NPI assigned

Feb 6, 2007

Last updated

Mar 7, 2023By the provider in NPPES

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) 778-6804

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Medical Center Pharmacy Other name

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

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1285774828",
    "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": "573-686-4556",
            "fax_number": "573-686-4529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "513B GRAND AVE",
            "city": "DONIPHAN",
            "state": "MO",
            "postal_code": "639351405",
            "telephone_number": "573-996-3784",
            "fax_number": "573-996-5275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OSAGE PHARMACY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-06",
        "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": "573-778-6804",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "MO",
            "license": "623809308",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "603809302",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "2637051",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Medical Center Pharmacy",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Richard E Musser Jr., D.O.
• Toni Needham, MA, CCC-SLP
• Danyelle Odom, PTA
• Kaley Renea Ormsby
• Osage Pharmacy LLC (Medical Center Pharmacy)
• Alagammai Ally Palaniappan, ALAGA PALANI, ALLY P
• Meyyappan Palaniappan, MD
• Christopher R Pinderski, MD
• Premiere Healthcare LLC (Medical Center Pharmacy)
• Premiere Healthcare LLC

• Durable Medical Equipment & Medical Supplies in Doniphan, MO
• Providers in Doniphan, 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.