National Provider Identifier Database

HINES STREET PHARMACY 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

HINES STREET PHARMACY LLC
1173 E HINES ST
REPUBLIC, MO65738-1277
Phone: 417-735-0055
Fax: 417-732-1529
Website:
Specialty Taxonomy Code
* Community/Retail Pharmacy 3336C0003X
Diabetes Educator 163WD0400X
Long Term Care Pharmacy 3336L0003X

* Indicates primary specialty

NPI Profile & details for HINES STREET PHARMACY LLC

NPI Number 1740559764
Legal business name
LBN
HINES STREET PHARMACY LLC
Authorized official STEPHEN MCCLANAHAN - (OWNER)
Entity Organization
Organization subpart No
Enumeration date 12/20/2011
Last updated 11/24/2020 - About 6 years ago
Sole proprietor1 Not specified
Identifiers
  • MO License #: 2012001548
  • MO Medicaid: 609551700
  • Other: 2133471 PK

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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