Tyler Batchelor
Individual provider Active NPI Pharmacist · Kennett, MO
NPI 1740958842 · NPPES record last updated Sep 2, 2021
Key facts
- NPI
- 1740958842
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 2019032438 (MO)
- Practice address
- 1300 1St St
Kennett, MO 63857-2526 - Phone
- (573) 888-8880
- NPI assigned
- Sep 2, 2021
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2019032438 | MO | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hometown Pharmacy - Bloomfield, LLC | Current | Accepting new patients | |
| Semo Drugs of Kennett Inc | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 2019032438 | MO | Yes |
Addresses
Primary practice location
1300 1St St
Kennett, MO 63857-2526
Mailing address
20075 State Highway 25
Bloomfield, MO 63825-8224
Phone (573) 625-2383
Other providers in Kennett, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 2, 2021. 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.