NPIMap

Organization Active NPI

South Central Missouri Community Health Center

Doing business as Four Rivers Pharmacy Salem

  • Pharmacy
  • Salem, MO
National Provider Identifier
1902763386
Registry record updated Jan 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
Legal business name
SOUTH CENTRAL MISSOURI COMMUNITY HEALTH CENTER
Doing business as
Four Rivers Pharmacy Salem
Practice address
703 S Grand Ave
Salem, MO 65560
Phone
(573) 426-4455
NPI assigned
Jan 7, 2026
Last updated
Jan 13, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Michelle Seibert
Title
Credentialing Specialist
Phone
(573) 426-4455

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X NU Primary

Addresses

Primary practice location

703 S Grand Ave
Salem, MO 65560

Mailing address

703 S Grand Ave
Salem, MO 65560
Phone (573) 426-4455

Other names 1

  • Four Rivers Pharmacy Salem Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250918001895 MO Part B Supplier - Pharmacy 1355513581 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Rolla, MO; Salem, MO

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory
Tax ID family
South Central Mo Center13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

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

Locations

703 S Grand St
Salem, MO 65560

NPI Registry JSON

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

{
    "created_epoch": "1767744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1768262400000",
    "number": "1902763386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "703 S GRAND AVE",
            "city": "SALEM",
            "state": "MO",
            "postal_code": "65560",
            "telephone_number": "573-426-4455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "703 S GRAND AVE",
            "city": "SALEM",
            "state": "MO",
            "postal_code": "65560",
            "telephone_number": "573-426-4455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH CENTRAL MISSOURI COMMUNITY HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-01-07",
        "last_updated": "2026-01-13",
        "certification_date": "2026-01-13",
        "status": "A",
        "authorized_official_last_name": "SEIBERT",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "573-426-4455"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Four Rivers Pharmacy Salem",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Salem, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.