NPIMap

Organization Active NPI

Landrum Drug Inc

Doing business as Landrum Drug

  • Community/Retail Pharmacy
  • Mount Vernon, MO
National Provider Identifier
1821264433
Registry record updated Jul 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
2008012584 Issued in MO
Legal business name
LANDRUM DRUG INC
Doing business as
Landrum Drug
Practice address
106 E Mount Vernon Blvd
Mount Vernon, MO 65712-2040
Phone
(417) 461-1100
Fax
(417) 461-1103
NPI assigned
May 3, 2008
Last updated
Jul 7, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2022

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

Authorized official

Name
Jill Freitas, RPHNPI 1851980478
Title
Owner/Pic/Secretary
Phone
(417) 461-1100

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 2008012584 MO Primary
Long Term Care Pharmacy 3336L0003X NU

Addresses

Primary practice location

106 E Mount Vernon Blvd
Mount Vernon, MO 65712-2040

Mailing address

106 E Mount Vernon Blvd
Mount Vernon, MO 65712-2040
Phone (417) 461-1100

Other identifiers 2

IdentifierTypeStateIssuer
1821264433MedicaidMO
2049640OtherPK

Other names 1

  • LANDRUM DRUG Doing business as

National Provider Directory

National Provider Directory

Locations

106 E Mount Vernon Blvd
Mount Vernon, MO 65712
Phone (417) 461-1100

1319 S Landrum St
Ste E
Mount Vernon, MO 65712
Phone (417) 461-1100

Practitioners & affiliated clinicians

Practitioners 2

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": "1209772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657152000000",
    "number": "1821264433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 E MOUNT VERNON BLVD",
            "city": "MOUNT VERNON",
            "state": "MO",
            "postal_code": "657122040",
            "telephone_number": "417-461-1100",
            "fax_number": "417-461-1103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 E MOUNT VERNON BLVD",
            "city": "MOUNT VERNON",
            "state": "MO",
            "postal_code": "657122040",
            "telephone_number": "417-461-1100",
            "fax_number": "417-461-1103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LANDRUM DRUG INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-03",
        "last_updated": "2022-07-07",
        "certification_date": "2022-07-07",
        "status": "A",
        "authorized_official_last_name": "FREITAS",
        "authorized_official_first_name": "JILL",
        "authorized_official_title_or_position": "OWNER/PIC/SECRETARY",
        "authorized_official_telephone_number": "417-461-1100",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MO",
            "license": "2008012584",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1821264433",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2049640",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LANDRUM DRUG",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "LANDRUM DRUG",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mount Vernon, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 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.