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Contact Information

MISSOURI MED LLC
2215 BROADWAY
SUITE B
CAPE GIRARDEAU, MO63701-4403
 Phone: 573-803-5500
 Fax: 573-803-5501
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Long Term Care Pharmacy

3336L0003X 58 Medical Supply Company with Pharmacist
 

Nursing Facility Supplies

332BN1400X 87 All Other Suppliers
 

Pharmacy

333600000X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for MISSOURI MED LLC

NPI Number 1518465533
LBN Legal business name MISSOURI MED LLC
Authorized official JACKIE MCHUGH - (OFFICE MANAGER)
Entity Organization
Organization subpart 1 No
Enumeration date 01/24/2018
Last updated 03/03/2026 - About 3 months ago
Identifiers
MO License # 2018005320
MO Medicaid 600051690
Other 2176054 PK
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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