Polaris Specialty Pharmacy LLC

Organization Active NPI Long Term Care Pharmacy · Riverside, MO

NPI 1831903798 · NPPES record last updated Nov 10, 2025

Key facts

NPI
1831903798
Entity type
Organization (NPI type 2)
Primary specialty
Long Term Care Pharmacy 3336L0003X
Legal business name
POLARIS SPECIALTY PHARMACY LLC
Practice address
206 NW Plaza Dr Ste 206
Riverside, MO 64150-9574
Phone
(314) 549-6300
Fax
(816) 897-4105
NPI assigned
Feb 3, 2025
Organization subpart
No

Authorized official

Name
Regina Hunt
Title
Corporate Director of Compliance Co
Phone
(800) 589-9747

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Corporate family (same tax ID) 7

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

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in MO

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20231218002297 MO Part B Supplier - Pharmacy 7517315666 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Riverside, MO
O20250812002449 MO DME Supplier - Pharmacy 7517315666 Practice locations: Riverside, MO

National Provider Directory

Tax ID family
Premier Pharmacy Services (8 organizations share this tax ID)

Locations

206 NW Plaza Dr
Riverside, MO 64150
Phone (314) 549-6300

206 NW Plaza Dr
Ste 206
Riverside, MO 64150
Phone (314) 549-6300

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Long Term Care Pharmacy 3336L0003X Yes

Addresses

Primary practice location

206 NW Plaza Dr Ste 206
Riverside, MO 64150-9574

Mailing address

2900 NW 60TH St
Fort Lauderdale, FL 33309-1774
Phone (800) 589-9747

Other names

  • Polaris Pharmacy Services of Missouri Doing business as

Other providers in Riverside, MO

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

Sources for this page

Verify at the official NPI Registry.