CLARK COUNTY PHARMACY INC (NPI# 1255806774) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255806774 |
| Entity Type | Organization |
| Organization Name | CLARK COUNTY PHARMACY INC |
| Practice Address |
250 S Johnson St Kahoka MO 63445-1635 |
| Practice Telephone | 6607272214 |
| Practice Fax Number | 6607272764 |
| Mailing Telephone | 6607272214 |
| Mailing Fax Number | 6607272764 |
| Enumeration Date | 2018-10-11 |
| Last Update Date | 2018-10-11 |
| Authorized Official Name | ANTHONY MCKEE (OWNER) |
| Authorized Official Telephone | 6607272214 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336L0003X |
Pharmacy Specialization: Long Term Care Pharmacy |
Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 600119309 | 05 |
| Other Name | Type Code |
|---|---|
| Clark County Pharmacy | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669651907 | Clark County Pharmacy Inc | Durable Medical Equipment & Medical Supplies | 111 E Monroe St, Memphis, MO 63555-1437 | 2007-11-02 |
| 1811022049 | Clark County Pharmacy Inc | Durable Medical Equipment & Medical Supplies | 250 S Johnson St, Kahoka, MO 63445-1635 | 2007-02-21 |
| 1477689370 | Clark County Pharmacy Inc | Durable Medical Equipment & Medical Supplies | 250 S Johnson St, Kahoka, MO 63445-1635 | 2007-02-26 |
| Street Address |
250 S JOHNSON ST |
| City | KAHOKA |
| State | MO |
| Zip Code | 63445-1635 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811022049 | Clark County Pharmacy Inc | Durable Medical Equipment & Medical Supplies | 250 S Johnson St, Kahoka, MO 63445-1635 | 2007-02-21 |
| 1477689370 | Clark County Pharmacy Inc | Durable Medical Equipment & Medical Supplies | 250 S Johnson St, Kahoka, MO 63445-1635 | 2007-02-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497286462 | Nicole Davolt | Community Health Worker | 112 N Johnson St., Kahoka, MO 63445 | 2017-03-22 |
| 1376953554 | Samantha Allen | Speech-Language Pathologist | 566 E Commercial St, Kahoka, MO 63445 | 2014-04-28 |
| 1558781443 | Athena Marie Duncan | Technician/Technologist | 450 N Johnson, Kahoka, MO 63445 | 2014-04-18 |
| 1124208137 | Lynne E Barbour Dds PC | Dentist | 203 E Commercial, Kahoka, MO 63445 | 2007-11-07 |
| 1700912276 | Exceed Physical Therapy LLC | Physical Therapist | 120 South Johnson Street, Kahoka, MO 63445 | 2007-02-26 |
| 1417047887 | Lynne Barbour | Dentist | 203 East Commercial, Kahoka, MO 63445-0025 | 2006-10-13 |
| 1366076929 | Kourtney Brooke Anderson | Occupational Therapy Assistant | 710 Newton Ave, Kahoka, MO 63445-1009 | 2020-02-23 |
| 1336761873 | Erin Protsman | Nurse Practitioner | 304 Westbrooke Dr, Kahoka, MO 63445-1052 | 2020-05-07 |
| 1194718908 | Clark County Nursing Home | Skilled Nursing Facility | 1260 N Johnson St, Kahoka, MO 63445-1100 | 2005-08-26 |
| 1851765960 | Jessica Dianne Boudreau | Occupational Therapy Assistant | 1260 N Johnson St, Kahoka, MO 63445-1100 | 2015-12-01 |
| Find all providers in zip 63445 | ||||
| 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] |
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| 1023620838 | Tipton Pharmacy | Pharmacy | 310 Us Highway 50 W, Tipton, MO 65081-8701 | 2020-08-21 |
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| 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 | ||||
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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.