Healthcare Provider Details

I. General information

NPI: 1013935279
Provider Name (Legal Business Name): CANOTE PHARMACY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/17/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

545 SKAGGS ROAD SUITE 1007
BRANSON MO
65616
US

IV. Provider business mailing address

545 SKAGGS ROAD SUITE 1007
BRANSON MO
65616
US

V. Phone/Fax

Practice location:
  • Phone: 417-332-0565
  • Fax: 417-332-0793
Mailing address:
  • Phone: 417-332-0565
  • Fax: 417-332-0793

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number2000157696
License Number StateMO

VIII. Authorized Official

Name: DR. HEATHER LEE BURNEY
Title or Position: PHARMACIST-IN-CHARGE, OWNER
Credential: PHARM.D.
Phone: 417-332-0565