Family Pharmacy of Mountain Grove LLC

Primary specialty

PharmacyTaxonomy code 333600000X

Legal business name

FAMILY PHARMACY OF MOUNTAIN GROVE LLC

Practice address

1600 N Main St
Mountain Grove, MO 65711-1010

Phone

(417) 926-9655

Fax

(417) 926-0045

NPI assigned

Feb 22, 2007

Last updated

Nov 18, 2024By 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

Christine Michelle CoffmanNPI 1124777362

Title

Owner/Pharmacist

Phone

(417) 926-4156

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in MO2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Medicare medical equipment & supply locations

Practitioners 6

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.

• Christine Michelle Coffman, RPH

  • Pharmacist
  • Mountain Grove, MO
  • NPI 1124777362
  NPD Authorized official
• Todd Robert Campbell, PHARMACIST

  • Pharmacist
  • Mountain Grove, MO
  • NPI 1497569057
  NPD (past)
• Brock Coffman

  • Pharmacist
  • Mountain Grove, MO
  • NPI 1215812664
  NPD (past)
• Cade Coffman

  • Pharmacist
  • Mountain Grove, MO
  • NPI 1316865421
  NPD (past)
• Taea Denise Emery

  • Pharmacy Technician
  • Mountain Grove, MO
  • NPI 1639994684
  NPD (past)
• Meagan Renee Newberry

  • Pharmacist
  • Mountain Grove, MO
  • NPI 1417811829
  NPD (past)

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731888000000",
    "number": "1851426852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 N MAIN ST",
            "city": "MOUNTAIN GROVE",
            "state": "MO",
            "postal_code": "657111010",
            "telephone_number": "417-926-9655",
            "fax_number": "417-926-0045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 N MAIN ST",
            "city": "MOUNTAIN GROVE",
            "state": "MO",
            "postal_code": "657111010",
            "telephone_number": "417-926-9655",
            "fax_number": "417-926-0045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY PHARMACY OF MOUNTAIN GROVE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-22",
        "last_updated": "2024-11-18",
        "certification_date": "2024-11-18",
        "status": "A",
        "authorized_official_last_name": "COFFMAN",
        "authorized_official_first_name": "CHRISTINE",
        "authorized_official_middle_name": "MICHELLE",
        "authorized_official_title_or_position": "OWNER/PHARMACIST",
        "authorized_official_telephone_number": "417-926-4156"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MO",
            "license": "200059684",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Taea Denise Emery
• Audrey Noel Emling
• Phillip John Emling
• Endeavor Chiropractic, LLC
• David Evans, LADAC, ICAADC, ACADC
• Family Walk in Clinic of Mountain Grove Inc (Family Walk-in Clinic of MTN. Grove, Inc.)
• Marcella Dawn Fleetwood, PLPC
• Melissa Freeman
• Charlee Gann, RDH
• Stephanie Renae Gerlek, LCSW

• Pharmacy in Mountain Grove, MO
• Providers in Mountain Grove, MO by specialty
• Pharmacy in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.