Jordan Valley Community Health Center Pharmacy #2

LBN: Advocates For A Healthy Community
Jordan Valley Community Health Center Pharmacy #2 is an health care organization with primary practice located at 440 E Tampa St , Springfield MO 65806-1131. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Clinic Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Advocates For A Healthy Community can be contacted via phone (417) 831-0150, or through Schryack, Ruth via phone (417) 831-0150.

Contact Information

Primary practice address
440 E Tampa St Springfield MO 65806-1131
Phone: (417) 831-0150
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Schryack, Ruth
Phone: (417) 831-0150

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Clinic Pharmacy 3336C0002X
Suppliers / Community/Retail Pharmacy 3336C0003X 2009017150 Missouri

Profile Details

NPI number 1033347828
LBN Legal business name Advocates For A Healthy Community
DBA Doing business as Jordan Valley Community Health Center Pharmacy #2
Authorized official Schryack, Ruth
Entity Organization
Organization subpart 1 No
Enumeration date Jun 30th, 2009
Last updated Jun 30th, 2009 - about 16 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1033347828 NPPES
Other 2638647 NCPDP PROVIDER IDENTIFICATION NUMBER

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