NPIMap

Organization Active NPI

Hines Street Pharmacy LLC

  • Long Term Care Pharmacy
  • Republic, MO
National Provider Identifier
1679252829
Registry record updated Jul 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
Legal business name
HINES STREET PHARMACY LLC
Practice address
1173 E Hines St
Republic, MO 65738-1277
Phone
(417) 735-0055
NPI assigned
Jul 14, 2023
Last updated
Jul 14, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
HINES STREET PHARMACY LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 14, 2023

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

Authorized official

Name
Stephen L McClanahanNPI 1487275707
Title
Owner
Phone
(417) 735-0055

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

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

Addresses

Primary practice location

1173 E Hines St
Republic, MO 65738-1277

Mailing address

1173 E Hines St
Republic, MO 65738-1277
Phone (417) 735-0055

National Provider Directory

National Provider Directory
Tax ID family
Hines Street Pharmacy LLC2 organizations share this tax ID, including this one
Part of
Hines Street Pharmacy LLC

Other organizations with this tax ID 1

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

Locations

1173 E Hines St
Republic, MO 65738
Phone (417) 735-0055

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.

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1689292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689292800000",
    "number": "1679252829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1173 E HINES ST",
            "city": "REPUBLIC",
            "state": "MO",
            "postal_code": "657381277",
            "telephone_number": "417-735-0055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1173 E HINES ST",
            "city": "REPUBLIC",
            "state": "MO",
            "postal_code": "657381277",
            "telephone_number": "417-735-0055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HINES STREET PHARMACY LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HINES STREET PHARMACY LLC",
        "enumeration_date": "2023-07-14",
        "last_updated": "2023-07-14",
        "certification_date": "2023-07-11",
        "status": "A",
        "authorized_official_last_name": "MCCLANAHAN",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "417-735-0055"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Republic, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 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.

Verify at the official NPI Registry.