City Pba Pharmacy
Organization Active NPI Community/Retail Pharmacy · Slater, MO
NPI 1376569228 · NPPES record last updated Dec 18, 2016
Key facts
- NPI
- 1376569228
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- License
- 003919 (MO)
- Legal business name
- CITY PBA PHARMACY
- Practice address
- 227 Main St
Slater, MO 65349-1411 - Phone
- (660) 529-2255
- Fax
- (660) 529-2701
- NPI assigned
- Jul 14, 2006
- Organization subpart
- No
Authorized official
- Name
- John Markovich, PD
- Title
- Owner Pressident
- Phone
- (660) 529-2255
Corporate family (same tax ID) 1
National Provider Directory
- Tax ID family
- City Pba Pharmacy
Locations
227 Main St
Slater, MO 65349
Phone (660) 529-2255
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | 003919 | MO | Yes |
Addresses
Primary practice location
227 Main St
Slater, MO 65349-1411
Mailing address
227 Main St
Slater, MO 65349-1411
Phone (660) 529-2255
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 600095418 | Medicaid | MO | |
| 2048676 | Other | PK |
Other names
- CITY PBA PHARMACY
Other providers in Slater, MO
- Heather Arnold
- Nicole P Bomar
- Theresa Ann Campbell
- City Pharmacy Inc.
- Cassandra Grace Eddy
- Steven Ellefsen
- Bridget Heaton Garner
- John Fitzgibbon Memorial Hospital Inc.
All providers in Slater, MO · Community/Retail Pharmacy in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 18, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.