Healthcare Provider Details

I. General information

NPI: 1700342888
Provider Name (Legal Business Name): BATTLEFIELD PHARMACY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/14/2019
Last Update Date: 03/08/2022
Certification Date: 03/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4062 W REPUBLIC RD
BATTLEFIELD MO
65619-7108
US

IV. Provider business mailing address

4062 W REPUBLIC RD
BATTLEFIELD MO
65619-7108
US

V. Phone/Fax

Practice location:
  • Phone: 417-730-1456
  • Fax: 417-890-0380
Mailing address:
  • Phone: 417-730-1456
  • Fax: 417-890-0380

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: DR. MATTHEW MCNITT
Title or Position: PHARMACIST/CO-OWNER
Credential: PHARMD
Phone: 417-730-1456