SAM'S PRESCRIPTION SHOP, INC. (NPI# 1114470598) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114470598 |
| Entity Type | Organization |
| Organization Name | SAM'S PRESCRIPTION SHOP, INC. |
| Other Organization Name | SAM'S HEALTH MART PHARMACY # 2 |
| Practice Address |
530 East 24 Highway Moberly MO 65270 |
| Mailing Address |
Po Box 957 Moberly MO 65270-0957 |
| Practice Telephone | 6602630615 |
| Practice Fax Number | 6602631541 |
| Mailing Telephone | 6602633309 |
| Mailing Fax Number | 6602633514 |
| Enumeration Date | 2016-08-02 |
| Last Update Date | 2020-09-14 |
| Authorized Official Name | CHRISTIAN TADRUS (OWNER) |
| Authorized Official Telephone | 6602633309 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 333600000X | Pharmacy | Suppliers | ||
| Y | 3336L0003X |
Pharmacy Specialization: Long Term Care Pharmacy |
2010042682 | MO | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2162343 | 01 | |
| MO | 600202824 | 05 |
| Other Name | Type Code |
|---|---|
| Sam's Health Mart Pharmacy # 2 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245709682 | Sam's Prescription Shop, Inc. | Durable Medical Equipment & Medical Supplies | 300 N. Morley Street, Moberly, MO 65270 | 2018-11-15 |
| Street Address |
530 EAST 24 HIGHWAY |
| City | MOBERLY |
| State | MO |
| Zip Code | 65270 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528376639 | Sams Prescription Shop Inc | Durable Medical Equipment & Medical Supplies | 530 East 24 Highway, Moberly, MO 65270-2500 | 2010-09-23 |
| 1841737582 | Anne C. Eisenbeis | Pharmacist | 530 East 24 Highway, Moberly, MO 65270 | 2017-01-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538628052 | Thomas Johnston | Physical Therapist | Thrive Physical Therapy, LLC, 417 E Urbandale Drive, Moberly, MO 65270 | 2019-03-14 |
| 1245709682 | Sam's Prescription Shop, Inc. | Durable Medical Equipment & Medical Supplies | 300 N. Morley Street, Moberly, MO 65270 | 2018-11-15 |
| 1639324585 | Trinidad J. Aguilera | General Practice | 5201 South Morley, Moberly, MO 65270 | 2008-11-19 |
| 1023270170 | Jessica Winn | Internal Medicine | 1513 Union Ave Ste 1500, Moberly, MO 65270 | 2008-06-30 |
| 1629237383 | Heather Ann Lavalley | Physical Therapy Assistant | 1346 S Morley, Moberly, MO 65270 | 2008-06-06 |
| 1265602429 | Mckenzie Prescription Center Inc | Hearing Aid Equipment | 643 N Morley St Ste A, Moberly, MO 65270 | 2008-03-04 |
| 1366624165 | Sharon Kay Steele | Military Hospital | 1510 Highway Jj Lot41, Moberly, MO 65270 | 2007-12-04 |
| 1932241536 | Christian S Tadrus | Pharmacist | 530 E. 24 Highway, (26-39586), Moberly, MO 65270 | 2007-02-12 |
| 1588700140 | Heartland Neurology, LLC | Psychiatry & Neurology | 300 N. Morley, Suite H, Moberly, MO 65270 | 2007-01-30 |
| 1164571519 | John James Oloughlin | Dentist | 1616 N Morely, Ste B, Moberly, MO 65270 | 2007-01-08 |
| Find all providers in zip 65270 | ||||
| Taxonomy Code | 3336L0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | 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 for mentally retarded, hospice, assisted living facilities, group homes, and other forms of congregate living arrangements. |
| 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: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174929723 | Hils, LLC | Pharmacy | 907 N Morley St, Moberly, MO 65270-2610 | 2014-11-10 |
| 1659987584 | Sams Prescription Shop Inc | Pharmacy | 300 N Morley St, Moberly, MO 65270-2334 | 2020-09-16 |
| 1831744580 | Hils, LLC | Pharmacy | 907 N Morley St, Moberly, MO 65270-2610 | 2019-08-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265033534 | Good Graces, LLC | Pharmacy | 857 E Main Street, Ste 3 - 5, Willow Springs, MO 65793 | 2020-11-03 |
| 1780298406 | Healthdirect Institutional Pharmacy Services, Inc. | Pharmacy | 4083 N State Highway Nn, Ozark, MO 65721-7201 | 2020-09-01 |
| 1023620838 | Tipton Pharmacy | Pharmacy | 310 Us Highway 50 W, Tipton, MO 65081-8701 | 2020-08-21 |
| 1568095313 | Auburn Pharmacy, Inc. | Pharmacy | 1103 S 169 Hwy, Smithville, MO 64089 | 2020-02-20 |
| 1780229690 | Dalpoas Group Inc | Pharmacy | 4245 Forest Park Ave Ste B, Saint Louis, MO 63108-2810 | 2019-11-14 |
| 1053953109 | Summers Pharmacy of Slater, LLC | Pharmacy | 102 E Maple St, Slater, MO 65349-1539 | 2019-10-10 |
| 1316594328 | Legacy Drugstore LLC | Pharmacy | 13000 Veterans Memorial Pkwy Ste A, Wright City, MO 63390-1012 | 2019-08-23 |
| 1972158673 | Hils Pharmacy Salisbury LLC | Pharmacy | 501 E. 24 Hwy Ste A, Salisbury, MO 65281 | 2019-08-08 |
| 1700342888 | Battlefield Pharmacy | Pharmacy | 4062 W Republic Rd, Battlefield, MO 65619-7108 | 2019-02-14 |
| 1548733769 | Guardian Pharmacy of St. Louis, LLC | Pharmacy | 926 S Highway Dr, Fenton, MO 63026-2023 | 2019-01-10 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on SAM'S PRESCRIPTION SHOP, INC..
| 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.