Active NPI
Perryville Healthcare Corporation
- Pharmacy
- Perryville, MO
National Provider Identifier
1508965534
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy
- License
- 006636
- Legal business name
- PERRYVILLE HEALTHCARE CORPORATION
- Practice address
- 212 Hospital LN Ste 102
Perryville, MO 63775-4204 - Phone
- (573) 547-4960
- Fax
- (573) 547-6540
- NPI assigned
- Sep 22, 2006
- Organization subpart
- Yes
- Parent organization
- PERRY COUNTY HEALTH SYSTEM
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Dana S. Cover, RPH
- Title
- Pharmacist in Charge
- Phone
- (573) 547-4960
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | 006636 | MO | Primary |
Addresses
Primary practice location
212 Hospital LN Ste 102
Perryville, MO 63775-4204
Mailing address
212 Hospital LN
Suite 102
Perryville, MO 63775-1276
Phone (573) 547-4960
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 604688606 | Medicaid | MO | |
| 2632722 | Other | MO | NABP NUMBER |
Other names 1
- Prescriptions Plus Pharmacy
National Provider Directory
National Provider Directory- Part of
- Perry County Community
Locations
212 Hospital Ln
Ste 102
Perryville, MO 63775
Phone (573) 547-2536
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158883200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1678147200000",
"number": "1508965534",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "212 HOSPITAL LN",
"address_2": "SUITE 102",
"city": "PERRYVILLE",
"state": "MO",
"postal_code": "637751276",
"telephone_number": "573-547-4960",
"fax_number": "573-547-6540"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "212 HOSPITAL LN STE 102",
"city": "PERRYVILLE",
"state": "MO",
"postal_code": "637754204",
"telephone_number": "573-547-4960",
"fax_number": "573-547-6540"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PERRYVILLE HEALTHCARE CORPORATION",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "PERRY COUNTY HEALTH SYSTEM",
"enumeration_date": "2006-09-22",
"last_updated": "2023-03-07",
"status": "A",
"authorized_official_last_name": "COVER",
"authorized_official_first_name": "DANA",
"authorized_official_middle_name": "S.",
"authorized_official_title_or_position": "PHARMACIST IN CHARGE",
"authorized_official_telephone_number": "573-547-4960",
"authorized_official_name_prefix": "Mr.",
"authorized_official_credential": "RPH"
},
"taxonomies": [
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": "MO",
"license": "006636",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "604688606",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NABP NUMBER",
"identifier": "2632722",
"state": "MO"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Prescriptions Plus Pharmacy",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Perryville, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.