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STATE OF MISSOURI NPI 1669511093


NPI Information

NPI: 1669511093
Provider Name: STATE OF MISSOURI

Doing Business As: SOUTHEAST MISSOURI MENTAL HEALTH CENTER PHARMACY

Classification: Pharmacy - 3336I0012X
Entity Type: Organization

Specialization: Institutional Pharmacy

Address:
1010 W COLUMBIA ST
FARMINGTON, MO
ZIP 63640
Phone: (573) 218-6759
Get Directions

STATE OF MISSOURI is an institutional pharmacy pharmacy in Farmington, MO. The provider is a pharmacy in a hospital (inpatient) or institution used by pharmacists for the compounding and delivery of medicinal preparations to be administered to the patient by nursing or other authorized personnel. Institutional Pharmacies also counsel patients and caregivers; 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. STATE OF MISSOURI NPI is 1669511093. The provider is registered as an organization entity type.
The provider Is Doing Business As Southeast Missouri Mental Health Center Pharmacy.

The provider's business location address is:

1010 W COLUMBIA ST
FARMINGTON, MO
ZIP 63640-902
Phone: (573) 218-6759
Fax: (573) 218-6762

The provider's authorized official is Molly Jane Boeckmann .
The authorized official title is Director Of Administrative Services and has the following contact phone number (573) 751-4055.

The enumeration date for this NPI number is 2/5/2007 and was last updated on 8/28/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1333600000XPharmacyNo
23336I0012XPharmacyInstitutional Pharmacy001820MISSOURIYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1050490200MEDICAIDMISSOURI
22048857OTHERPK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.