Austin Plaza Pharmacy Inc

Key facts

NPI

1366545592

Entity type

Organization (NPI type 2)

Primary specialty

Community/Retail Pharmacy 3336C0003X

License

002790 (MO)

Legal business name

AUSTIN PLAZA PHARMACY INC

Practice address

410 E High St Ste a
Potosi, MO 63664-1927

Phone

(573) 438-2349

Fax

(573) 438-8877

NPI assigned

Sep 6, 2006

Organization subpart

No

Authorized official

Name

Kellie Thompson

Title

President

Phone

(573) 768-1529

National Provider Directory

Locations

Specialties & licenses

Addresses

Other identifiers

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jan 4, 2018.

{
    "created_epoch": "1157500800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1515024000000",
    "number": "1366545592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 E HIGH ST STE A",
            "city": "POTOSI",
            "state": "MO",
            "postal_code": "636641927",
            "telephone_number": "573-438-2349",
            "fax_number": "573-438-8877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 E HIGH ST STE A",
            "city": "POTOSI",
            "state": "MO",
            "postal_code": "636641927",
            "telephone_number": "573-438-2349",
            "fax_number": "573-438-8877"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "410 E High St",
            "address_purpose": "LOCATION",
            "city": "Potosi",
            "state": "MO",
            "postal_code": "636641927",
            "country_code": "US",
            "telephone_number": "573-438-2349",
            "fax_number": "573-438-8877",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "AUSTIN PLAZA PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-06",
        "last_updated": "2018-01-04",
        "status": "A",
        "authorized_official_last_name": "THOMPSON",
        "authorized_official_first_name": "KELLIE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "573-768-1529"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MO",
            "license": "002790",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2049323",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "600095905",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Potosi, MO

• Kamal Akhtar, FNP
• David Orie Albert Sr., O.D.
• Patricia Louise Allen, APRN
• Ally Care LLC
• Bethany Renae Aubuchon, LCSW
• Michelle Danielle Barnes, AE-C
• Michael Dennis Barnum, M.D.
• Timothy Will Christopher Bass, M.D.
• Kallie Belfield
• Mackenzie Bennett

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