Mackenzie Lane Morrison, PHARMD

Individual provider Active NPI Pharmacist · Gallatin, MO

NPI 1851917850 · NPPES record last updated Jun 25, 2020

Key facts

NPI
1851917850
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacist 183500000X
License
2008027918 (MO)
Practice address
403 S Main St
Gallatin, MO 64640-1434
Phone
(660) 663-7979
Fax
(816) 295-2354
NPI assigned
Jun 25, 2020
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
2008027918MOMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Main Street Medical Pharmacy, LLC Past
since Jun 28, 2020
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 2008027918 MO Yes

Addresses

Primary practice location

403 S Main St
Gallatin, MO 64640-1434

Mailing address

403 S Main St
Gallatin, MO 64640-1434
Phone (660) 663-7979

Other identifiers

IdentifierTypeStateIssuer
2008027918OtherMOMISSOURI BOARD OF PHARMACY PHARMACIST LICENSE

Other providers in Gallatin, MO

All providers in Gallatin, MO · Pharmacist in Missouri

Sources for this page

Verify at the official NPI Registry.