PRESCRIPTION DRUG STORE LLC (NPI# 1497790968) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497790968 |
| Entity Type | Organization |
| Organization Name | PRESCRIPTION DRUG STORE LLC |
| Practice Address |
410 Ward Ave Caruthersville MO 63830 |
| Practice Telephone | 5733334890 |
| Practice Fax Number | 5733330306 |
| Mailing Telephone | 5733334890 |
| Mailing Fax Number | 5733330306 |
| Enumeration Date | 2006-06-18 |
| Last Update Date | 2011-10-03 |
| Authorized Official Name | MR. SHANE A. DUDLEY (RPH MANAGER) |
| Authorized Official Telephone | 5733334890 |
| Authorized Official Credential | R.PH |
| Is Organization Subpart | Y |
| Parent Organization Name | JERRY KELLY DUDLEY |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
000915 | MO | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 600126106 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952554693 | Prescription Drug Store LLC | Durable Medical Equipment & Medical Supplies | 410 Ward Ave, Caruthersville, MO 63830-1451 | 2008-10-28 |
| 1861645509 | Prescription Drug Store LLC | Durable Medical Equipment & Medical Supplies | 308 E Main St, Hayti, MO 63851-1639 | 2008-10-28 |
| 1235175100 | Prescription Drug Store LLC | Pharmacy | 308 E Main St, Hayti, MO 63851-1639 | 2006-06-21 |
| Street Address |
410 WARD AVE |
| City | CARUTHERSVILLE |
| State | MO |
| Zip Code | 63830 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902247869 | Dax Owen Melugin | Pharmacist | 410 Ward Ave, Caruthersville, MO 63830-1451 | 2013-07-08 |
| 1952554693 | Prescription Drug Store LLC | Durable Medical Equipment & Medical Supplies | 410 Ward Ave, Caruthersville, MO 63830-1451 | 2008-10-28 |
| 1154455673 | Shane A Dudley | Pharmacist | 410 Ward Ave, Caruthersville, MO 63830-1451 | 2007-03-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689216400 | Jazmyne S Hall | Behavior Technician | 915 Highway 84, Caruthersville, MO 63830 | 2019-10-14 |
| 1134573017 | Nathan Straeter | Pharmacist | State Highway 84 West, Caruthersville, MO 63830 | 2016-04-18 |
| 1861805624 | Ashley Marie Ballard | Case Manager/Care Coordinator | 10 & Ward Suite C, Caruthersville, MO 63830 | 2014-06-09 |
| 1356764435 | Jena Payne | Case Manager/Care Coordinator | 10th Ward St, Caruthersville, MO 63830 | 2014-01-27 |
| 1619390705 | James Smith | Case Manager/Care Coordinator | 10th & Ward Suite B, Caruthersville, MO 63830 | 2014-01-27 |
| 1730501370 | Belinda Fields | Community Health Worker | 10th & Ward, C, Caruthersville, MO 63830 | 2014-01-16 |
| 1831387372 | T M Swinger & D V Mckillip, Ptr | Optometrist | 101 E. 10th St., Suite A, Caruthersville, MO 63830 | 2007-10-10 |
| 1437284635 | Terrence M Swinger | Optometrist | 101 E. Tenth St., Suite A, Caruthersville, MO 63830 | 2007-02-21 |
| 1114097581 | John D Gardner | Dentist | 1210 Ward Ave, Caruthersville, MO 63830 | 2006-11-09 |
| 1366512287 | Krilurk Chanvitayapongs | Pharmacist | 2709 South Ward, Caruthersville, MO 63830 | 2006-11-08 |
| Find all providers in zip 63830 | ||||
| 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 |
|---|---|---|---|---|
| 1154435121 | Ecb Pharmacy Inc | Pharmacy | 1200 Ward Ave, Caruthersville, MO 63830-2204 | 2006-08-18 |
| 1477693174 | Hayden Drug Company, Inc. | Pharmacy | 1200 Ward Ave, Caruthersville, MO 63830-2204 | 2007-02-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699374629 | Curators of The University of Missouri | Pharmacy | 7115 East St. Charles Road, Columbia, MO 65202 | 2020-10-21 |
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| 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 | CARUTHERSVILLE |
| Zip Code | 63830 |
Please comment or provide details below to improve the information on PRESCRIPTION DRUG STORE 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.