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Contact Information

CARROLL CNTY MEM HOSP PHARMACY INC
1502 N JEFFERSON ST
CARROLLTON, MO64633-1948
 Phone: 660-542-1695
 Fax: 660-542-0363
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Institutional Pharmacy

3336I0012X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for CARROLL CNTY MEM HOSP PHARMACY INC

NPI # 1942316708
LBN Legal business name CARROLL CNTY MEM HOSP PHARMACY INC
Authorized official JERRY DOVER - (CEO)
Entity Organization
Organization subpart 1 No
Enumeration date 08/22/2006
Last updated 08/22/2020 - About 6 years ago
Identifiers
MO License # 21044
MO Medicaid 0909150
Other 2623266 OTHER ID NUMBER-COMMERCIAL NUMBER
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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