MEDICARE: WEBBER PHARMACY, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336L0003X	Long Term Care Pharmacy

General Provider Information

NPI Number	:	1245912765
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WEBBER PHARMACY, INC

Provider Business Mailing Address
First Line	:	1101 W MONROE ST
Second Line	:
City	:	MEXICO
State	:	MO
Zip	:	65265-1977
Country	:	US
Telephone Number	:	573-581-7561
Fax Number	:

Provider Business Practice Location Address
First Line	:	1101 W MONROE ST
Second Line	:
City	:	MEXICO
State	:	MO
Zip	:	65265-1977
Country	:	US
Telephone Number	:	573-581-7561
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	BRENDAN WEBBER
Credential	:
Telephone Number	:	573-581-7561

Provider Enumeration Date	:	08/03/2023
Last Update Date	:	08/03/2023

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Directions to “WEBBER PHARMACY, INC ” Practice Location

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