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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
13336C0003XCommunity/Retail Pharmacy
23336L0003XLong Term Care Pharmacy
3333600000XPharmacy2016027108MO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12163848OTHERPK

General Provider Information

NPI Number : 1942540026
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 : 573-276-2134
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 :
Authorized Official
Title or Position : PHARMACY MANAGER
Name : STEPHANIE LINDSEY
Credential :
Telephone Number : 573-996-1347
Provider Enumeration Date : 02/26/2013
Last Update Date : 08/31/2017

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Directions to “WILKARE PHARMACY LLC ” Practice Location

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