Chillicothe Family Pharmacy, LLC

Organization Active NPI Community/Retail Pharmacy · Chillicothe, MO

NPI 1407245012 · NPPES record last updated May 14, 2019

Key facts

NPI
1407245012
Entity type
Organization (NPI type 2)
Primary specialty
Community/Retail Pharmacy 3336C0003X
License
2015012618 (MO)
Legal business name
CHILLICOTHE FAMILY PHARMACY, LLC
Practice address
504 S Washington St
Chillicothe, MO 64601-3038
Phone
(660) 240-0828
Fax
(660) 070-0019
NPI assigned
Jan 20, 2015
Organization subpart
No

Authorized official

Name
Dr. Scott A Cady, PHARMD NPI 1023039799
Title
Pic/ Co-Owner
Phone
(660) 240-0828

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

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
O20151012000582 MO DME Supplier - Pharmacy 1658682778 Practice locations: Chillicothe, MO
O20190403001911 MO Part B Supplier - Pharmacy 1658682778 Practice locations: Chillicothe, MO

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Diabetes Educator Registered Nurse
Group: 193400000X SINGLE SPECIALTY GROUP
163WD0400X
Durable Medical Equipment & Medical Supplies 332B00000X 2015012618 MO
Community/Retail Pharmacy 3336C0003X 2015012618 MO Yes

Addresses

Primary practice location

504 S Washington St
Chillicothe, MO 64601-3038

Mailing address

504 S Washington St
Chillicothe, MO 64601-3038
Phone (660) 240-0828

Other identifiers

IdentifierTypeStateIssuer
600021831MedicaidMO

Other providers in Chillicothe, MO

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

Sources for this page

Verify at the official NPI Registry.