Nicole McHargue Neal, PHARMD
Individual provider Active NPI Community/Retail Pharmacy · Gallatin, MO
NPI 1497319206 · NPPES record last updated Apr 26, 2019
Key facts
- NPI
- 1497319206
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- License
- 2019013549 (MO)
- Practice address
- 403 S Main St
Gallatin, MO 64640-1434 - Phone
- (660) 663-7979
- Fax
- (660) 663-2963
- NPI assigned
- Apr 26, 2019
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2019013549 | MO | MD | Community/Retail Pharmacy |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Main Street Medical Pharmacy, LLC | Community/Retail Pharmacy | Current | Accepting new patients |
Locations
403 S Main St
Gallatin, MO 64640
Phone (660) 663-7979
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | 2019013549 | MO | Yes |
Addresses
Primary practice location
403 S Main St
Gallatin, MO 64640-1434
Mailing address
403 S Main St
Gallatin, MO 64640-1434
Phone (660) 663-7979
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 045026 | Other | MO | MISSOURI STATE BOARD OF PHARMACY PHARMACIST LICENSE |
| 2500053920 | Other | MO | BNDD LICENSE |
| 2019013549 | Other | MO | MISSOURI STATE BOARD OF PHARMACY PERMIT |
Other providers in Gallatin, MO
- Ip Reserve
- Kristina Renee Lee
- Zachery C. Mahler
- Main Street Medical Pharmacy, LLC
- Mackenzie Lane Morrison
- Northwest Health Services Inc
- Northwest Health Services Inc
- Northwest Health Services Inc
- Cindy Michelle O'Rourke
- Orourke Wellness Center PC
All providers in Gallatin, 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 Apr 26, 2019. 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.