Health Care Pharmacy of Perryville, LLC
Organization Active NPI Long Term Care Pharmacy · Perryville, MO
NPI 1902461908 · NPPES record last updated Dec 3, 2021
Key facts
- NPI
- 1902461908
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Long Term Care Pharmacy 3336L0003X
- Legal business name
- HEALTH CARE PHARMACY OF PERRYVILLE, LLC
- Practice address
- 628 N Old St Marys Rd
Perryville, MO 63775 - Phone
- (573) 547-2517
- NPI assigned
- May 6, 2019
- Organization subpart
- No
Authorized official
- Name
- Savanna Grogg
- Title
- Manager
- Phone
- (573) 535-4911
Corporate family (same tax ID) 1
National Provider Directory
- Tax ID family
- Health Care Pharmacy of Perryville LLC
Locations
628 Old St Marys Rd
Perryville, MO 63775
Phone (573) 547-2517
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | |||
| Long Term Care Pharmacy | 3336L0003X | Yes |
Addresses
Primary practice location
628 N Old St Marys Rd
Perryville, MO 63775
Mailing address
628 N Old St Marys Rd
Perryville, MO 63775
Phone (573) 547-2517
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 600123608 | Medicaid | MO |
Other names
- HEALTHCARE HEALTHWISE PHARMACY
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | OTHER |
Other providers in Perryville, MO
- Dominic Jeffrey Haertling
- Amanda Sue Hager
- Bruce E Harrison
- Deborah Hayden
- Health Care Pharmacy of Perryville, LLC
- Courtney Heberlie
- Brad E. Hennemann
- Jessica Hennemann
- Sara Hennemann
- Tracie Ann Higgins
All providers in Perryville, MO · Long Term Care Pharmacy in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 3, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.