Hines Street Pharmacy LLC

Organization Active NPI Long Term Care Pharmacy · Republic, MO

NPI 1679252829 · NPPES record last updated Jul 14, 2023

Key facts

NPI
1679252829
Entity type
Organization (NPI type 2)
Primary specialty
Long Term Care Pharmacy 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
Organization subpart
Yes
Parent organization (as reported)
HINES STREET PHARMACY LLC

Authorized official

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

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.

Corporate family (same tax ID) 1

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

National Provider Directory

Tax ID family
Hines Street Pharmacy LLC (2 organizations share this tax ID)
Part of
Hines Street Pharmacy LLC

Specialties & licenses

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

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

Other providers in Republic, MO

All providers in Republic, MO · Long Term Care Pharmacy in Missouri

Sources for this page

Verify at the official NPI Registry.