Johnston Drug Inc
Organization Active NPI Community/Retail Pharmacy · Clarence, MO
NPI 1962403592 · NPPES record last updated Mar 7, 2017
Key facts
- NPI
- 1962403592
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- License
- 004095 (MO)
- Legal business name
- JOHNSTON DRUG INC
- Practice address
- 214 N Grand St
Clarence, MO 63437-1604 - Phone
- (660) 699-2432
- Fax
- (660) 699-3873
- NPI assigned
- Aug 4, 2005
- Organization subpart
- No
Authorized official
- Name
- James Johnston, PHARMD
- Title
- Owner / President
- Phone
- (660) 699-2432
Practitioners 3
-
James Johnston, PHARM D
-
Alicyn Grace Magruder, PHARMD
-
Lynn Perrigo, PHARMD
Laboratory certificates & supplier records
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| Johnston Drug Inc |
Nebulizer Drugs|Oral Anticancer Drugs|Blood Glucose Monitors/Supplies (Non-Mail Order)|Blood Glucose Monitors/Supplies (Mail Order)|Canes and/or Crutches|Breast Prostheses and/or Accessories|Ostomy Supplies|Urological Supplies|Enteral Nutrients|Enteral Equipment and/or Supplies|Surgical Dressings|D… | Does not accept assignment |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in MO
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100930013495 | MO | DME Supplier - Pharmacy |
8123145943 | Practice locations: Clarence, MO |
| O20110920000439 | MO | Part B Supplier - Pharmacy | 8123145943 | Practice locations: Clarence, MO |
National Provider Directory
Locations
214 N Grand St
Clarence, MO 63437
Phone (660) 699-2432
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | 004095 | MO | Yes |
| Compounding Pharmacy | 3336C0004X |
Addresses
Primary practice location
214 N Grand St
Clarence, MO 63437-1604
Mailing address
PO Box 96
Clarence, MO 63437-0096
Phone (660) 699-2432
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2050331 | Other | PK | |
| 601811102 | Medicaid | MO |
Other names
- JOHNSTON DRUG INC
Other providers in Clarence, MO
- Jessica Renee Carroll
- Clarence Nursing Home District
- Conie Clark
- Creative Enterprises of Clarence
- Creative Enterprises of Clarence
- Bryce William Johnston
- James Johnston
- Dwight Moody Jones Jr.
- Alicyn Grace Magruder
- Madison Lynn Moody
All providers in Clarence, MO · Community/Retail 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 Mar 7, 2017. 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.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.