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SAMS PRESCRIPTION SHOP INC NPI 1568453397


NPI Information

NPI: 1568453397
Provider Name: SAMS PRESCRIPTION SHOP INC

Doing Business As: SAM'S HEALTH MART PHARMACY

Classification: Pharmacy - 3336C0003X
Entity Type: Organization

Specialization: Community/Retail Pharmacy

CLIA Number: 26D1090328

Address:
300 N MORLEY ST
MOBERLY, MO
ZIP 65270
Phone: (660) 263-0909
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SAMS PRESCRIPTION SHOP INC is a community/retail pharmacy pharmacy in Moberly, MO. The provider is 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. SAMS PRESCRIPTION SHOP INC NPI is 1568453397. The provider is registered as an organization entity type.
The provider Is Doing Business As Sam's Health Mart Pharmacy.

The provider's business location address is:

300 N MORLEY ST
MOBERLY, MO
ZIP 65270-334
Phone: (660) 263-0909
Fax: (660) 263-2124

The provider's authorized official is Christian Tadrus .
The authorized official title is Owner and has the following contact phone number (660) 263-3309.

The CLIA number assigned to this NPI record is 26D1090328 - pharmacy with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/1/2005 and was last updated on 8/24/2022.


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
1332B00000XDurable Medical Equipment & Medical SuppliesNo
2333600000XPharmacyNo
33336C0004XPharmacyCompounding PharmacyNo
43336S0011XPharmacySpecialty PharmacyNo
53336C0003XPharmacyCommunity/Retail Pharmacy003205MISSOURIYes

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
12049295OTHERPK
2600061105MEDICAIDMISSOURI

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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