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MISSOURI MED LLC NPI 1518465533


NPI Information

NPI: 1518465533
Provider Name: MISSOURI MED LLC

Doing Business As: MISSOURI MED, LLC

Classification: Pharmacy - 3336L0003X
Entity Type: Organization

Specialization: Long Term Care Pharmacy

Address:
2215 BROADWAY
SUITE B
CAPE GIRARDEAU, MO
ZIP 63701
Phone: (573) 803-5500
Get Directions

MISSOURI MED 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. MISSOURI MED LLC NPI is 1518465533. The provider is registered as an organization entity type.
The provider Is Doing Business As Missouri Med, Llc.

The provider's business location address is:

2215 BROADWAY
SUITE B
CAPE GIRARDEAU, MO
ZIP 63701-403
Phone: (573) 803-5500
Fax: (573) 803-5501

The provider's authorized official is Shafiq Malik .
The authorized official title is President and has the following contact phone number (573) 335-3044.

The enumeration date for this NPI number is 1/24/2018 and was last updated on 11/16/2022.


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
1332BN1400XDurable Medical Equipment & Medical SuppliesNursing Facility Supplies2018005320MISSOURINo
2333600000XPharmacyNo
33336L0003XPharmacyLong Term Care PharmacyYes

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
1600051690MEDICAIDMISSOURI
22176054OTHERPK

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: 4/28/2024

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