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NPI Code Detail

MEDICARE: WILKARE PHARMACY LLC

MEDICARE: WILKARE PHARMACY LLC
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
13336L0003XLong Term Care Pharmacy2016027108MO

General Provider Information

NPI Number : 1871075325
Entity Type Code : Organization
Provider Name (Legal Business Name) : WILKARE PHARMACY LLC
Provider Business Mailing Address
First Line : 214 W MAIN ST
Second Line :
City : MALDEN
State : MO
Zip : 63863-2114
Country : US
Telephone Number : 573-276-3784
Fax Number : 573-276-2144
Provider Business Practice Location Address
First Line : 214 W MAIN ST
Second Line :
City : MALDEN
State : MO
Zip : 63863-2114
Country : US
Telephone Number : 573-276-3784
Fax Number : 573-276-2144
Authorized Official
Title or Position : OWNER
Name : PHILLIP KEITH WILKINS
Credential : PHARMD
Telephone Number : 573-276-3784
Provider Enumeration Date : 08/31/2018
Last Update Date : 08/31/2018

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Directions to “WILKARE PHARMACY LLC ” Practice Location

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