LEGACY DRUGSTORE LLC (NPI# 1316594328) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316594328 |
| Entity Type | Organization |
| Organization Name | LEGACY DRUGSTORE LLC |
| Practice Address |
13000 Veterans Memorial Pkwy Ste A Wright City MO 63390-1012 |
| Practice Telephone | 6367911274 |
| Practice Fax Number | 6367911326 |
| Mailing Telephone | 6367911274 |
| Mailing Fax Number | 6367911326 |
| Enumeration Date | 2019-08-23 |
| Last Update Date | 2019-08-23 |
| Authorized Official Name | MITCH GRAUMENZ (PRESIDENT) |
| Authorized Official Telephone | 6367911274 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336L0003X |
Pharmacy Specialization: Long Term Care Pharmacy |
Suppliers |
| Other Name | Type Code |
|---|---|
| Legacy Drugstore | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396291837 | Legacy Drugstore LLC | Pharmacy | 13000 Veterans Memorial Pkwy, Suite A, Wright City, MO 63390-1041 | 2016-08-25 |
| Street Address |
13000 VETERANS MEMORIAL PKWY STE A |
| City | WRIGHT CITY |
| State | MO |
| Zip Code | 63390-1012 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932470556 | Cheryl Parsons | Physical Therapist | #65 State Highway Aa, Wright City, MO 63390 | 2012-01-13 |
| 1356423982 | Joseph Herbert Gerard | Chiropractor | 409b Warren Avenue, Wright City, MO 63390 | 2006-10-20 |
| 1093790883 | Marcel E Haulard | Family Medicine | 305 W N 2nd St, Wright City, MO 63390 | 2005-12-14 |
| 1215069547 | Carol L Hohenstreet | Occupational Therapist | 402 North Service Rd, R-ii, Wright City, MO 63390-0198 | 2007-03-12 |
| 1780716019 | Rebecca L Mallett | Physical Therapist | Wright City R-ii School District, 402 North Service Road, Wright City, MO 63390-0198 | 2007-03-12 |
| 1679605844 | Rebecca Lynn Peters | Speech-Language Pathologist | Wright City R-ii School District, 402 North Service Road, Wright City, MO 63390-0198 | 2007-03-12 |
| 1396291837 | Legacy Drugstore LLC | Pharmacy | 13000 Veterans Memorial Pkwy, Suite A, Wright City, MO 63390-1041 | 2016-08-25 |
| 1790983468 | Linda Sue Kettmann | Counselor | 201 North Cherry St, Wright City, MO 63390-1130 | 2007-07-04 |
| 1558559708 | Kathleen Y. Newman | Social Worker | 505 Staghorn Ln, Wright City, MO 63390-1823 | 2007-10-11 |
| 1063969103 | Kelly Anders | Behavioral Analyst | 1000 Moon Valley Ln, Wright City, MO 63390-2114 | 2016-09-07 |
| Find all providers in zip 63390 | ||||
| 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 |
| 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 |
| 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 |
| 1346718418 | Gideon Pharmacy LLC | Pharmacy | 111 N Main St., Gideon, MO 63848 | 2018-11-07 |
| Find all providers with the same taxonomy | ||||
| City | WRIGHT CITY |
| Zip Code | 63390 |
Please comment or provide details below to improve the information on LEGACY DRUGSTORE LLC.
| 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.