Organization · Type 2 NPI

State of Missouri

Long Term Care Pharmacy · St. Joseph, MO

NPI number 1750420188 Active

Practice location

3505 Frederick Ave
St. Joseph, MO 64506-2914

Call (816) 387-2564 Map

Fax (816) 387-2391

Mailing address

1706 E Elm St
Jefferson City, MO 65101-4130

Specialties and licenses

Taxonomy	Code	License
Long Term Care Pharmacy Primary	3336L0003X	None listed

Long Term Care Pharmacy: A pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermediate care facilities, hospice, assisted living facilities, group homes, and other forms of congregate living arrangements.

27 other providers at this address

Other long term care pharmacy providers in St. Joseph

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NPI record

NPI: 1750420188
Entity type: Organization (Type 2)
Issued: Feb 5, 2007
Last updated: Sep 3, 2020
Status: Active
Subpart: Yes of State of Missouri

Other names

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Northwest Mo PRC Pharmacy · doing business as
Northwest Mo PRC Pharmacy · doing business as

Authorized official

Molly Jane Boeckmann
Director of Administrative Services
(573) 751-4055

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1750420188

State of Missouri's National Provider Identifier is 1750420188, issued on Feb 5, 2007. The primary taxonomy on file is Long Term Care Pharmacy (3336L0003X), and the practice location is in St. Joseph, MO. The record was last updated on Sep 3, 2020.