SAM'S PRESCRIPTION SHOP, INC. (NPI# 1245709682) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245709682 |
| Entity Type | Organization |
| Organization Name | SAM'S PRESCRIPTION SHOP, INC. |
| Practice Address |
300 N. Morley Street Moberly MO 65270 |
| Mailing Address |
Po Box 957 Moberly MO 65270-0957 |
| Practice Telephone | 6602630909 |
| Practice Fax Number | 6602632124 |
| Mailing Telephone | 6602633309 |
| Mailing Fax Number | 6602633514 |
| Enumeration Date | 2018-11-15 |
| Last Update Date | 2018-11-15 |
| Authorized Official Name | CHRISTIAN S TADRUS (OFFICER) |
| Authorized Official Telephone | 6602633309 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| N | 332BN1400X |
Durable Medical Equipment & Medical Supplies Specialization: Nursing Facility Supplies |
Suppliers | ||
| N | 332S00000X | Hearing Aid Equipment | Suppliers | ||
| N | 208U00000X | Clinical Pharmacology | Allopathic & Osteopathic Physicians | ||
| N | 3336C0004X |
Pharmacy Specialization: Compounding Pharmacy |
Suppliers | ||
| N | 3336L0003X |
Pharmacy Specialization: Long Term Care Pharmacy |
Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MEDICARE MASS IMMUNIZATION BILLING NUMBER | MA3507 | 01 | |
| MO | MISSOURI TAX ID NUMBER | 10735224 | 01 |
| Other Name | Type Code |
|---|---|
| Sam's Health Mart Pharmacies | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 300 N. Church Street, Fayette, MO 65248 | 6602482275 | 6602482858 |
| 530 E. 24 Highway, Moberly, MO 65270 | 6602636710 | 6602632269 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114470598 | Sam's Prescription Shop, Inc. | Pharmacy | 530 East 24 Highway, Moberly, MO 65270 | 2016-08-02 |
| Street Address |
300 N. MORLEY STREET |
| City | MOBERLY |
| State | MO |
| Zip Code | 65270 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538628052 | Thomas Johnston | Physical Therapist | Thrive Physical Therapy, LLC, 417 E Urbandale Drive, Moberly, MO 65270 | 2019-03-14 |
| 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 |
| 1558421248 | Michael Wade Harrod | Dentist | 5201 South Morley St., Moberly, MO 65270 | 2006-12-11 |
| Find all providers in zip 65270 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. |
| 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 |
|---|---|---|---|---|
| 1538253224 | Mckenzie Prescription Center Inc | Pharmacy | 643 N Morley St, Suite A, Moberly, MO 65270-2500 | 2006-10-03 |
| 1669513594 | Moberly Professional Arts Pharmacy Inc. | Pharmacy | 1513 Union Ave, Moberly, MO 65270-9407 | 2007-02-12 |
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|---|---|---|---|---|
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| 1912517897 | Rpcs, Inc. | Pharmacy | 1447 State Highway 248 Ste J, Branson, MO 65616-8161 | 2020-08-05 |
| 1245849801 | Rpcs Inc | Pharmacy | 163 W Old Mill Rd, Fair Grove, MO 65648-7918 | 2020-07-29 |
| 1760005219 | Meta Pharmacy Solutions | Pharmacy | 108 Triad Ctr W, O Fallon, MO 63366-7541 | 2020-05-19 |
| 1437778172 | Harps Food Stores, Inc | Pharmacy | 707 Specialty Dr, Dexter, MO 63841-2718 | 2020-04-13 |
| 1013540038 | Auburn Pharmacy Inc | Pharmacy | 810 W 35th St Ste 101, Higginsville, MO 64037-1865 | 2020-02-18 |
| 1801428495 | Scpg Missouri LLC | Pharmacy | 501 South Madison Ave, Suite S, Webb City, MO 64870 | 2020-02-11 |
| Find all providers with the same taxonomy | ||||
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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.