Red Cross Pharmacy, Inc
Organization Active NPI Pharmacy · Harrisonville, MO
NPI 1922090158 · NPPES record last updated Nov 4, 2010
Key facts
- NPI
- 1922090158
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Pharmacy 333600000X
- License
- 004160 (MO)
- Legal business name
- RED CROSS PHARMACY, INC
- Practice address
- 103 E Mechanic St
Harrisonville, MO 64701-2461 - Phone
- (816) 380-3321
- Fax
- (816) 887-5206
- NPI assigned
- Aug 15, 2005
- Organization subpart
- No
Authorized official
- Name
- Scott B Hartwig
- Title
- Co-President/Ceo
- Phone
- (660) 886-5535
Other NPIs on the same Medicare enrollment 19
Member of 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040929000382 | MO | Part B Supplier - Mass Immunization (Roster Biller Only) | 2466421102 |
20 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Excelsior Springs, MO; Marshall, MO |
National Provider Directory
Locations
103 E Mechanic St
Harrisonville, MO 64701
Phone (816) 380-3321
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | 2008025199 | MO | |
| Pharmacy | 333600000X | 004160 | MO | Yes |
Addresses
Primary practice location
103 E Mechanic St
Harrisonville, MO 64701-2461
Mailing address
PO Box 917
Marshall, MO 65340-0917
Phone (660) 886-5535
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 600280705 | Medicaid | MO |
Other providers in Harrisonville, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 4, 2010. 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.