Active NPI
Family Pharmacy of Missouri LLC
- Pharmacy
- Nixa, MO
National Provider Identifier
1366417214
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy
- License
- 3679
- Legal business name
- FAMILY PHARMACY OF MISSOURI LLC
- Practice address
- 924 W Mt Vernon
Nixa, MO 65714 - Phone
- (417) 725-2624
- Fax
- (417) 725-2625
- NPI assigned
- Feb 22, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Lynn A Morris, R.PH
- Title
- Owner
- Phone
- (417) 581-4335
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Pharmacy | 333600000X | 3679 | MO | Primary |
Addresses
Primary practice location
924 W Mt Vernon
Nixa, MO 65714
Mailing address
PO Box 1440
Nixa, MO 65714-1440
Phone (417) 725-2624
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 626189609 | Other | MO | MEDICAID DME |
| 626189609 | Medicaid | MO | |
| 2616653 | Other | MO | NCPDP |
| 600058028 | Medicaid | MO |
Other names 1
- Family Pharmacy #3
National Provider Directory
National Provider DirectoryLocations
924 W Mount Vernon St
Nixa, MO 65714
Phone (417) 725-2624
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Pharmacist
- Nixa, MO
- NPI 1053589952
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1140566400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1204761600000",
"number": "1366417214",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1440",
"city": "NIXA",
"state": "MO",
"postal_code": "657141440",
"telephone_number": "417-725-2624",
"fax_number": "417-725-2625"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "924 W MT VERNON",
"city": "NIXA",
"state": "MO",
"postal_code": "65714",
"telephone_number": "417-725-2624",
"fax_number": "417-725-2625"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "FAMILY PHARMACY OF MISSOURI LLC",
"organizational_subpart": "NO",
"enumeration_date": "2006-02-22",
"last_updated": "2008-03-06",
"status": "A",
"authorized_official_last_name": "MORRIS",
"authorized_official_first_name": "LYNN",
"authorized_official_middle_name": "A",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "417-581-4335",
"authorized_official_credential": "R.PH"
},
"taxonomies": [
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": null,
"license": null,
"primary": false
},
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": "MO",
"license": "3679",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAID DME",
"identifier": "626189609",
"state": "MO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "626189609",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NCPDP",
"identifier": "2616653",
"state": "MO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "600058028",
"state": "MO"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Family Pharmacy #3",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Nixa, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.