Town and Country Grocers of Fredericktown Mo Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

2006035969 Issued in MO

Legal business name

TOWN AND COUNTRY GROCERS OF FREDERICKTOWN MO INC

Doing business as

Country Mart

Practice address

301 T J Stewart Dr
Park Hills, MO 63601-2500

Phone

(573) 431-8537

Fax

(573) 431-2514

NPI assigned

Dec 6, 2006

Last updated

Feb 10, 2010By 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

Bobbie Joe Hufford

Title

Owner President

Phone

(573) 783-5703

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• COUNTRY MART Doing business as

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1265760000000",
    "number": "1831258839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 T J STEWART DR",
            "city": "PARK HILLS",
            "state": "MO",
            "postal_code": "636012500",
            "telephone_number": "573-431-8537",
            "fax_number": "573-431-2514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 T J STEWART DR",
            "city": "PARK HILLS",
            "state": "MO",
            "postal_code": "636012500",
            "telephone_number": "573-431-8537",
            "fax_number": "573-431-2514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOWN AND COUNTRY GROCERS OF FREDERICKTOWN MO INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-06",
        "last_updated": "2010-02-10",
        "status": "A",
        "authorized_official_last_name": "HUFFORD",
        "authorized_official_first_name": "BOBBIE JOE",
        "authorized_official_title_or_position": "OWNER PRESIDENT",
        "authorized_official_telephone_number": "573-783-5703"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MO",
            "license": "2006035969",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "2637265",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "COUNTRY MART",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Patricia Stubbs, LPN
• The Eye Studio LLC
• Constance M Thomas, RNC WHNP
• Brigitte A Thorn
• Mary Lou Tongay, FNP-C
• Tracy L Tucker, FNP-BC
• Carla Sue Vasquez, R.D.H.
• Crystal Warren, RN
• Jessica Weber, LPC
• Melinda Ann Weber, LCSW

• Community/Retail Pharmacy in Park Hills, MO
• Providers in Park Hills, 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 Feb 10, 2010; 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.