Mountain Grove Pharmacy

LBN: Mountain Grove Pharmacy Inc
Mountain Grove Pharmacy is an health care organization with primary practice located at 106 N Union St , Mountain Grove MO 65711-1724. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Mountain Grove Pharmacy Inc can be contacted via phone (417) 926-4156, or through Coffman, Christine via phone (417) 926-9655.

Contact Information

Primary practice address
106 N Union St Mountain Grove MO 65711-1724
Phone: (417) 926-4156
Fax: (417) 926-4125
Website:
Map and Directions
Authorized official contact:
Name: Coffman, Christine
Phone: (417) 926-9655

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X 2015006569 Missouri

Profile Details

NPI number 1285645820
LBN Legal business name Mountain Grove Pharmacy Inc
DBA Doing business as Mountain Grove Pharmacy
Authorized official Coffman, Christine
Entity Organization
Organization subpart 1 No
Enumeration date Aug 10th, 2006
Last updated Aug 24th, 2023 - about 2 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 1285645820 NPPES
Missouri MEDICAID 601091507
Missouri Other 2049297

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