LEGACY DRUGSTORE LLC (NPI# 1396291837) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396291837 |
| Entity Type | Organization |
| Organization Name | LEGACY DRUGSTORE LLC |
| Other Organization Name | LEGACY DRUGSTORE |
| Practice Address |
13000 Veterans Memorial Pkwy Suite A Wright City MO 63390-1041 |
| Practice Telephone | 6367911274 |
| Practice Fax Number | 6367911326 |
| Mailing Telephone | 6367911274 |
| Mailing Fax Number | 6367911326 |
| Enumeration Date | 2016-08-25 |
| Last Update Date | 2016-12-21 |
| Authorized Official Name | MITCHELL GRAUMENZ (PIC) |
| Authorized Official Telephone | 6182670574 |
| Authorized Official Credential | PHARMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 333600000X | Pharmacy | Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
2016040867 | MO | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2163841 | 01 | |
| MO | 600037942 | 05 |
| Other Name | Type Code |
|---|---|
| Legacy Drugstore | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316594328 | Legacy Drugstore LLC | Pharmacy | 13000 Veterans Memorial Pkwy Ste A, Wright City, MO 63390-1012 | 2019-08-23 |
| Street Address |
13000 VETERANS MEMORIAL PKWY SUITE A |
| City | WRIGHT CITY |
| State | MO |
| Zip Code | 63390-1041 |
| 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 |
| 1316594328 | Legacy Drugstore LLC | Pharmacy | 13000 Veterans Memorial Pkwy Ste A, Wright City, MO 63390-1012 | 2019-08-23 |
| 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 | 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 |
|---|---|---|---|---|
| 1699374629 | Curators of The University of Missouri | Pharmacy | 7115 East St. Charles Road, Columbia, MO 65202 | 2020-10-21 |
| 1376141143 | Phillips Pharmacy, LLC | Pharmacy | 7278 State Highway 14 E, Sparta, MO 65753-9345 | 2020-10-14 |
| 1013527761 | Rpcs, Inc. | Pharmacy | 18128 State Hwy 13, Branson West, MO 65737 | 2020-08-07 |
| 1205446184 | Rpcs, Inc. | Pharmacy | 200 Southtowne Blvd, Hollister, MO 65672-9610 | 2020-08-05 |
| 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 | ||||
| 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.