BJC BEHAVIORAL HEALTH (NPI# 1114268935) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114268935 |
| Entity Type | Organization |
| Organization Name | BJC BEHAVIORAL HEALTH |
| Other Organization Name | BJC BEHAVIORAL SOUTHEAST PHARMACY |
| Practice Address |
1085 Maple St Farmington MO 63640-1955 |
| Practice Telephone | 5737565353 |
| Mailing Telephone | 5737565353 |
| Enumeration Date | 2013-03-04 |
| Last Update Date | 2019-03-06 |
| Authorized Official Name | MR. DANIEL ROTHERY (PRESIDENT) |
| Authorized Official Telephone | 3149531699 |
| Is Organization Subpart | Y |
| Parent Organization Name | BJC BEHAVIORAL HEALTH |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251S00000X | Community/Behavioral Health | Agencies | ||
| Y | 333600000X | Pharmacy | Suppliers |
| Other Name | Type Code |
|---|---|
| BJC Behavioral Southeast Pharmacy | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518251073 | Bjc Behavioral Health | Community/Behavioral Health | 233 Savannah Garden Dr, O Fallon, MO 63366-3220 | 2011-06-01 |
| 1053646380 | Bjc Behavioral Health | Community/Behavioral Health | 1085 Maple Street, Farmington, MO 63640 | 2009-10-05 |
| 1427590371 | Bjc Behavioral Health | Community/Behavioral Health | 1430 Olive St, Suite 400, Saint Louis, MO 63103-2303 | 2016-11-09 |
| 1356795090 | Bjc Behavioral Health | Clinic/Center | 1430 Olive St, Suite 400, Saint Louis, MO 63103-2303 | 2016-04-19 |
| 1598142770 | Bjc Behavioral Health | Community/Behavioral Health | 1085 Maple St, Farmington, MO 63640-1955 | 2015-04-27 |
| 1801215652 | Bjc Behavioral Health | Case Management | 1430 Olive St, Suite 500, Saint Louis, MO 63103-2303 | 2014-04-09 |
| 1790072262 | Bjc Behavioral Health | Community/Behavioral Health | 3165 Mckelvey Rd Ste 200, Bridgeton, MO 63044-2550 | 2011-07-06 |
| 1144520008 | Bjc Behavioral Health | Case Management | 343 S Kirkwood Rd Ste 200, Kirkwood, MO 63122-6195 | 2010-10-26 |
| 1134455561 | Bjc Behavioral Health | Community/Behavioral Health | 343 S Kirkwood Rd, Saint Louis, MO 63122-6195 | 2009-10-20 |
| 1114252004 | Bjc Behavioral Health | Case Management | 343 S Kirkwood Rd Ste 2, Saint Louis, MO 63122-6195 | 2009-10-09 |
| Street Address |
1085 MAPLE ST |
| City | FARMINGTON |
| State | MO |
| Zip Code | 63640-1955 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730193848 | Jennifer Lynn Beard | Social Worker | 1085 Maple St, Farmington, MO 63640-1955 | 2006-07-27 |
| 1710585716 | Sheri Lynn Ketcherside | Specialist | 1085 Maple St, Farmington, MO 63640-1955 | 2020-10-12 |
| 1821603887 | Ronni Kay Dubois | Social Worker | 1085 Maple St, Farmington, MO 63640-1955 | 2020-09-15 |
| 1306451372 | Melissa Gail Parson | Social Worker | 1085 Maple St, Farmington, MO 63640-1955 | 2020-09-15 |
| 1043825912 | Kayla Luber | Behavior Technician | 1085 Maple St, Farmington, MO 63640-1955 | 2020-09-08 |
| 1912521030 | Adam Feltes | Behavioral Analyst | 1085 Maple St, Farmington, MO 63640-1955 | 2020-06-04 |
| 1841824125 | Benjamin Carl Wilson | Case Manager/Care Coordinator | 1085 Maple St, Farmington, MO 63640-1955 | 2020-02-26 |
| 1285268482 | Jockese Martin | Social Worker | 1085 Maple St, Farmington, MO 63640-1955 | 2020-02-26 |
| 1528607991 | Felecia Elders | Technician, Other | 1085 Maple St, Farmington, MO 63640-1955 | 2020-01-02 |
| 1033758404 | Jeannie Bray | Technician, Other | 1085 Maple St, Farmington, MO 63640-1955 | 2020-01-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316545254 | Brenda S Halton | Nurse Practitioner | 1010 West Columbia Street, Farmington, MO 63640 | 2020-10-13 |
| 1619519089 | Stacey Nicole Gillette | Counselor | 17885 Hart Pinkston Rd, Farmington, MO 63640 | 2019-10-17 |
| 1346890696 | Christopher Ryan Massey | Social Worker | 607 Pine St., Farmington, MO 63640 | 2019-09-18 |
| 1457909376 | Clarice Ogden | Social Worker | 203 South Washington Street, Farmington, MO 63640 | 2019-09-04 |
| 1861979718 | Clint Thebeau | In Home Supportive Care | 1276 W Liberty St, Farmington, MO 63640 | 2018-07-24 |
| 1023500600 | Lynn Machelle Knox | Counselor | 219 W Columbia St, Farmington, MO 63640 | 2018-05-31 |
| 1235620576 | Kim Bazzell | Registered Nurse | 1565 Ste. Genevieve Ave., Farmington, MO 63640 | 2018-05-22 |
| 1164919742 | Lincare Inc. | Durable Medical Equipment & Medical Supplies | 774 Market St, Farmington, MO 63640 | 2018-04-18 |
| 1184127813 | Michelle Lynette Corvallis | Chiropractor | 17 South Franklin St., Farmington, MO 63640 | 2018-03-08 |
| 1992206213 | Farmington Vision Care LLC | Optometrist | 110 E Harrison St, Farmington, MO 63640 | 2018-02-22 |
| Find all providers in zip 63640 | ||||
| Taxonomy Code | 333600000X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: added definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568759058 | Mt Blue Drug Inc | Pharmacy | 624 Wilton Rd, Farmington, ME 04938-6138 | 2011-07-05 |
| 1295052306 | Farmington Village Pharmacy Pllc | Pharmacy | 32736 Grand River Ave, Farmington, MI 48336-3132 | 2010-04-28 |
| 1629131248 | Millers Pharmacy of Farmington | Pharmacy | 6181 Route 96, Farmington, NY 14425-1004 | 2006-12-18 |
| 1619043379 | Town & Country Grocers of Fredericktown Mo Inc | Pharmacy | 125 W Karsch Blvd, Farmington, MO 63640-2156 | 2006-11-27 |
| 1053338939 | Tayler Health LLC | Pharmacy | 32316 Grand River Ave, Farmington, MI 48336-3201 | 2006-07-16 |
| 1851316483 | Smiths Food & Drug Centers Inc | Pharmacy | 1316 N Highway 89, Farmington, UT 84025-3841 | 2006-07-13 |
| 1386669935 | Bormans Inc | Pharmacy | 22128 Farmington Rd, Farmington, MI 48336-4010 | 2006-07-13 |
| 1275564254 | Kmart of Michigan Inc | Pharmacy | 37175 Grand River Ave, Farmington, MI 48335-2821 | 2006-07-06 |
| 1649772351 | Med-mart Pharmacy LLC | Pharmacy | 100 Main Street, Farmington, WV 26571 | 2018-03-08 |
| 1720492564 | Walmart Inc. | Pharmacy | 367 W Main St, Farmington, AR 72730-2622 | 2014-06-19 |
| Find all providers in FARMINGTON | ||||
| City | FARMINGTON |
| Zip Code | 63640 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.