NPIMap

Organization Active NPI

Missouri Med LLC

Doing business as Missouri Med St Louis

  • Long Term Care Pharmacy
  • Saint Louis, MO
National Provider Identifier
1477412963
Registry record updated Jan 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
Legal business name
MISSOURI MED LLC
Doing business as
Missouri Med St Louis
Practice address
11643 Lilburn Park Rd
Saint Louis, MO 63146-3535
Phone
(314) 445-2900
NPI assigned
Jan 20, 2026
Organization subpart
Yes
Parent organization
MISSOURI MED LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 20, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Jackie McHugh
Title
Office Manager
Phone
(573) 335-3044

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Long Term Care Pharmacy 3336L0003X Primary

Addresses

Primary practice location

11643 Lilburn Park Rd
Saint Louis, MO 63146-3535

Mailing address

2215 Broadway St
Cape Girardeau, MO 63701-4403
Phone (573) 335-3044

Other names 1

  • MISSOURI MED ST LOUIS Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Missouri Med LLC2 organizations share this tax ID, including this one
Part of
Missouri Med LLC

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1768867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1768867200000",
    "number": "1477412963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2215 BROADWAY ST",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637014403",
            "telephone_number": "573-335-3044",
            "fax_number": "573-335-6724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11643 LILBURN PARK RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631463535",
            "telephone_number": "314-445-2900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSOURI MED LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MISSOURI MED LLC",
        "enumeration_date": "2026-01-20",
        "last_updated": "2026-01-20",
        "certification_date": "2026-01-20",
        "status": "A",
        "authorized_official_last_name": "MCHUGH",
        "authorized_official_first_name": "JACKIE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "573-335-3044"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MISSOURI MED ST LOUIS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2026; 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.