Organization Active NPI

Family Pharmacy of Missouri LLC

  • Pharmacy
  • Nixa, MO
National Provider Identifier
1447225412
Registry record updated Apr 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
2004026659 Issued in MO
Legal business name
FAMILY PHARMACY OF MISSOURI LLC
Practice address
105 S Ridgecrest Ave
Suite 1 & 2
Nixa, MO 65714-7807
Phone
(417) 724-2601
Fax
(417) 724-2621
NPI assigned
Feb 22, 2006
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Lynn A Morris, R.PH.
Title
Owner/President
Phone
(417) 581-4335

Practitioners 2

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

National Provider Directory

National Provider Directory

Specialties & licenses 3

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Pharmacy 333600000X 2004026659 MO Primary
Long Term Care Pharmacy 3336L0003X

Addresses

NPPES NPI Registry

Primary practice location

105 S Ridgecrest Ave
Suite 1 & 2
Nixa, MO 65714-7807

Mailing address

PO Box 1440
Nixa, MO 65714-1440
Phone (417) 724-2601

Other identifiers 4

NPPES NPI Registry
IdentifierTypeStateIssuer
606155802MedicaidMO
626155808MedicaidMO
626155808OtherMOMEDICAID DME
2635677OtherMONCPDP

Other names 1

NPPES NPI Registry
  • Family Pharmacy #14 Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Apr 6, 2017.

{
    "created_epoch": "1140566400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491436800000",
    "number": "1447225412",
    "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": "417-724-2601",
            "fax_number": "417-724-2621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 S RIDGECREST AVE",
            "address_2": "SUITE 1 & 2",
            "city": "NIXA",
            "state": "MO",
            "postal_code": "657147807",
            "telephone_number": "417-724-2601",
            "fax_number": "417-724-2621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY PHARMACY OF MISSOURI LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-22",
        "last_updated": "2017-04-06",
        "status": "A",
        "authorized_official_last_name": "MORRIS",
        "authorized_official_first_name": "LYNN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "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": "2004026659",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "606155802",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "626155808",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID DME",
            "identifier": "626155808",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "2635677",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Pharmacy #14",
            "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 Apr 6, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.