National Provider Identifier Database

PRESCRIPTION DRUG STORE LLC
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.


Contact Information

PRESCRIPTION DRUG STORE LLC
410 WARD AVE
CARUTHERSVILLE, MO63830
Phone: 573-333-4890
Fax: 573-333-0306
Website:
Specialty Taxonomy Code
* Community/Retail Pharmacy 3336C0003X
Long Term Care Pharmacy 3336L0003X

* Indicates primary specialty

NPI Profile & details for PRESCRIPTION DRUG STORE LLC

NPI Number 1497790968
Legal business name
LBN
PRESCRIPTION DRUG STORE LLC
Authorized official SHANE DUDLEY - (OWNER / PHARMACIST)
Entity Organization
Organization subpart No
Enumeration date 06/18/2006
Last updated 01/28/2022 - About 4 years ago
Sole proprietor1 Not specified
Identifiers
  • MO License #: 000915
  • MO Medicaid: 600126106

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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