Family Pharmacy of Missouri LLC

Primary specialty

PharmacyTaxonomy code 333600000X

License

2004031235 Issued in MO

Legal business name

FAMILY PHARMACY OF MISSOURI LLC

Doing business as

Family Pharmacy #16

Practice address

49 E Old Mill Rd
Fair Grove, MO 65648-8452

Phone

(417) 759-6300

Fax

(417) 759-6305

NPI assigned

Feb 20, 2006

Last updated

Apr 6, 2017By 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

Lynn A Morris, R.PH.

Title

President

Phone

(417) 759-6300

Specialties & licenses 3

Addresses

Other identifiers 4

Other names 1

• Family Pharmacy #16 Doing business as

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

{
    "created_epoch": "1140393600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491436800000",
    "number": "1881669208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 244",
            "city": "FAIR GROVE",
            "state": "MO",
            "postal_code": "656480244",
            "telephone_number": "417-759-6300",
            "fax_number": "417-759-6305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "49 E OLD MILL RD",
            "city": "FAIR GROVE",
            "state": "MO",
            "postal_code": "656488452",
            "telephone_number": "417-759-6300",
            "fax_number": "417-759-6305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY PHARMACY OF MISSOURI LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-20",
        "last_updated": "2017-04-06",
        "status": "A",
        "authorized_official_last_name": "MORRIS",
        "authorized_official_first_name": "LYNN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "417-759-6300",
        "authorized_official_credential": "R.PH."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "MO",
            "license": "2004031235",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "626166607",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID DME",
            "identifier": "626166607",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "2635766",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "606166601",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Pharmacy #16",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jereme Ajaz Azeez, PHARMD, RPH
• Back Home Chiropractic LLC
• Kathy L. Brite, COTA/L
• Amanda Crain
• Fair Grove R-X
• Shawna Sue Gulick, MSW, LCSW
• Heartland LLC
• Evelyn Kerby
• Kayce Knaup
• Katie Larue

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2017; 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.