Semo Drug Of Kennett

LBN: Semo Drug Of Kennett
Semo Drug Of Kennett is an health care organization with primary practice located at 1312 1St St , Kennett MO 63857-2526. The organization recently has only one registered license in Suppliers / Pharmacy, which is considered as the primary health care specialty. Semo Drug Of Kennett can be contacted via phone (573) 888-8880, or through Wallace, Tyson via phone (573) 888-8880.

Contact Information

Primary practice address
1312 1St St Kennett MO 63857-2526
Phone: (573) 888-8880
Fax: (573) 888-3889
Website:
Map and Directions
Authorized official contact:
Name: Wallace, Tyson PHARM.D.
Phone: (573) 888-8880

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X

Profile Details

NPI number 1053514356
LBN Legal business name Semo Drug Of Kennett
DBA Doing business as
Authorized official Wallace, Tyson PHARM.D.
Entity Organization
Organization subpart 1 No
Enumeration date Jun 6th, 2007
Last updated Aug 22nd, 2020 - about 6 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 1053514356 NPPES
Missouri MEDICAID 858466006

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