Bruners Monett Pharmacy Inc
Organization Active NPI Durable Medical Equipment & Medical Supplies · Monett, MO
NPI 1922089549 · NPPES record last updated Mar 23, 2023
Key facts
- NPI
- 1922089549
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Durable Medical Equipment & Medical Supplies 332B00000X
- Legal business name
- BRUNERS MONETT PHARMACY INC
- Practice address
- 321 E Broadway St
Monett, MO 65708-2329 - Phone
- (417) 235-3139
- Fax
- (417) 235-8058
- NPI assigned
- Nov 10, 2005
- Organization subpart
- No
Authorized official
- Name
- John M Bruner, RPH
- Title
- Owner
- Phone
- (417) 235-3139
Other NPIs on the same Medicare enrollment 1
Other NPIs with the same Medicare PAC ID 1
Practitioners 3
-
John Michael Bruner, RPH
-
Andrew James Bahl, RPH
-
Trenton Patton, PHARMD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100930001443 | MO | DME Supplier - Pharmacy |
7719005198 |
1 other NPI on this enrollment Practice locations: Monett, MO |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | Yes |
Addresses
Primary practice location
321 E Broadway St
Monett, MO 65708-2329
Mailing address
321 E Broadway St
Monett, MO 65708-2329
Phone (417) 235-3139
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 620093807 | Medicaid | MO |
NPI Registry JSON
{
"created_epoch": "1131580800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1679529600000",
"number": "1922089549",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "321 E BROADWAY ST",
"city": "MONETT",
"state": "MO",
"postal_code": "657082329",
"telephone_number": "417-235-3139",
"fax_number": "417-459-4783"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "321 E BROADWAY ST",
"city": "MONETT",
"state": "MO",
"postal_code": "657082329",
"telephone_number": "417-235-3139",
"fax_number": "417-235-8058"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BRUNERS MONETT PHARMACY INC",
"organizational_subpart": "NO",
"enumeration_date": "2005-11-10",
"last_updated": "2023-03-23",
"certification_date": "2023-03-23",
"status": "A",
"authorized_official_last_name": "BRUNER",
"authorized_official_first_name": "JOHN",
"authorized_official_middle_name": "M",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "417-235-3139",
"authorized_official_credential": "RPH"
},
"taxonomies": [
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "620093807",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Monett, MO
- Paul H. Bricker
- Jennifer Brown
- Lauren Marie Brown
- John Michael Bruner
- Bruners Monett Pharmacy Inc
- Tiana Burnside
- Nichole Norgard Carnahan
- Boyd D Carpenter
- Jeffrey David Carr
- Lina Carrasco Rodriguez
All providers in Monett, MO · Durable Medical Equipment & Medical Supplies in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 23, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.