BROADWAY LTC LLC NPI 1457758153

NPI Information

BROADWAY LTC, LLC is a long term care pharmacy pharmacy in Cape Girardeau, MO. The provider is a pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermediate care facilities, hospice, assisted living facilities, group homes, and other forms of congregate living arrangements. BROADWAY LTC, LLC NPI is 1457758153. The provider is registered as an organization entity type.
The provider Is Doing Business As Broadway Pharmacy Ltc.

The provider's business location address is:

37 DOCTORS PARK STE 7
CAPE GIRARDEAU, MO
ZIP 63703
Phone: (573) 803-2040

The provider's authorized official is Kevin Wood .
The authorized official title is Director Of Pharmacy and has the following contact phone number (573) 576-3029.

The CLIA number assigned to this NPI record is 26D2214267 - pharmacy with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/24/2014 and was last updated on 7/24/2018.

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:

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