Healthcare Provider Details

I. General information

NPI: 1669814182
Provider Name (Legal Business Name): PARKLAND PHARMACY DEVELOPMENT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/25/2013
Last Update Date: 01/25/2025
Certification Date: 01/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 N HIGHWAY 21
IRONTON MO
63650-9147
US

IV. Provider business mailing address

1025 HIGHWAY 72 BYP
FREDERICKTOWN MO
63645-7326
US

V. Phone/Fax

Practice location:
  • Phone: 573-546-6000
  • Fax: 573-546-6001
Mailing address:
  • Phone: 573-783-6000
  • Fax: 573-783-6008

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number2013024667
License Number StateMO

VIII. Authorized Official

Name: LISA UMFLEET
Title or Position: SECRETARY OF LLC, OWNER
Credential: RPH
Phone: 573-747-8333