NPIMap

Organization Active NPI

KB Kirksville Pharmacy LLC

Doing business as Kirksville Pharmacy

  • Long Term Care Pharmacy
  • Kirksville, MO
National Provider Identifier
1326684689
Registry record updated Dec 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
Legal business name
KB KIRKSVILLE PHARMACY LLC
Doing business as
Kirksville Pharmacy
Practice address
1611 S Baltimore St Ste B
Kirksville, MO 63501-4521
Phone
(660) 956-7010
NPI assigned
Nov 21, 2019
Last updated
Dec 12, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2019

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

Authorized official

Name
Kevin Alan McCulloughNPI 1679609721
Title
Owner
Phone
(417) 876-3313

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Long Term Care Pharmacy 3336L0003X Primary

Addresses

Primary practice location

1611 S Baltimore St Ste B
Kirksville, MO 63501-4521

Mailing address

209 E US Highway 54
El Dorado Springs, MO 64744-1925
Phone (417) 876-3313

Other names 1

  • Kirksville Pharmacy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
KB Kirksville Pharmacy LLC2 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.

Locations

209 E US Highway 54
El Dorado Springs, MO 64744
Phone (417) 876-3313

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.

NPI Registry JSON

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

{
    "created_epoch": "1574294400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1576108800000",
    "number": "1326684689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 E US HIGHWAY 54",
            "city": "EL DORADO SPRINGS",
            "state": "MO",
            "postal_code": "647441925",
            "telephone_number": "417-876-3313",
            "fax_number": "417-876-2326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1611 S BALTIMORE ST STE B",
            "city": "KIRKSVILLE",
            "state": "MO",
            "postal_code": "635014521",
            "telephone_number": "660-956-7010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KB KIRKSVILLE PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-21",
        "last_updated": "2019-12-12",
        "certification_date": "2019-12-12",
        "status": "A",
        "authorized_official_last_name": "MCCULLOUGH",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "417-876-3313"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kirksville Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kirksville, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2019; 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.