Bruners Monett Pharmacy Inc

Organization Active NPI Community/Retail Pharmacy · Monett, MO

NPI 1336285121 · NPPES record last updated Mar 23, 2023

Key facts

NPI
1336285121
Entity type
Organization (NPI type 2)
Primary specialty
Community/Retail Pharmacy 3336C0003X
License
002253 (MO)
Legal business name
BRUNERS MONETT PHARMACY INC
Practice address
321 E Broadway St
Monett, MO 65708-2329
Phone
(417) 235-3139
Fax
(417) 459-4783
NPI assigned
Jan 29, 2007
Organization subpart
No

Authorized official

Name
Mr. John Bruner, RPH
Title
Owner
Phone
(417) 235-3139

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in MO

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20100930001443 MO DME Supplier - Pharmacy
DME Supplier - Orthotic Personnel
7719005198 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Monett, MO
O20250730002173 MO Part B Supplier - Pharmacy 7719005198 Practice locations: Monett, MO

National Provider Directory

Locations

321 E Broadway St
Monett, MO 65708
Phone (417) 235-3139

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 002253 MO Yes

Addresses

Primary practice location

321 E Broadway St
Monett, MO 65708-2329

Mailing address

321 E Broadway St
Monett, MO 65708-2329
Phone (417) 235-3139

Other identifiers

IdentifierTypeStateIssuer
1922089549OtherMONPI FOR MEDICAL EQUIPMENT
2602236OtherMONCPDP NUMBER
600093801MedicaidMO

Other providers in Monett, MO

All providers in Monett, MO · Community/Retail Pharmacy in Missouri

Sources for this page

Verify at the official NPI Registry.