Professional Prescription Services LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

2004029045 Issued in MO

Legal business name

PROFESSIONAL PRESCRIPTION SERVICES LLC

Doing business as

Parkland Health Mart Pharmacy

Practice address

348 Festus Centre Dr
Festus, MO 63028-2458

Phone

(636) 933-2224

Fax

(636) 933-2264

NPI assigned

Sep 20, 2005

Last updated

Jun 23, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Douglas Rademaker, RPHNPI 1730658634

Title

Managing Member

Phone

(636) 933-2224

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Parkland Health Mart Pharmacy Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Douglas Rademaker

  • Pharmacist
  • Festus, MO
  • NPI 1730658634
  NPD Authorized official

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

{
    "created_epoch": "1127174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655942400000",
    "number": "1639165160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1131 N DESLOGE DR",
            "city": "DESLOGE",
            "state": "MO",
            "postal_code": "636012936",
            "telephone_number": "573-431-6677",
            "fax_number": "573-431-3833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "348 FESTUS CENTRE DR",
            "city": "FESTUS",
            "state": "MO",
            "postal_code": "630282458",
            "telephone_number": "636-933-2224",
            "fax_number": "636-933-2264"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL PRESCRIPTION SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-20",
        "last_updated": "2022-06-23",
        "certification_date": "2022-06-23",
        "status": "A",
        "authorized_official_last_name": "RADEMAKER",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "636-933-2224",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MO",
            "license": "2004029045",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2049048",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "606159507",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Parkland Health Mart Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Festus, MO
• Providers in Festus, MO by specialty
• Community/Retail Pharmacy in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2022; 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.