Healthcare Provider Details

I. General information

NPI: 1376919043
Provider Name (Legal Business Name): MINUTEMAN PHARMACY1ST LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2015
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

545 S BUSINESS HIGHWAY 13
LEXINGTON MO
64067-1437
US

IV. Provider business mailing address

545 S BUSINESS HIGHWAY 13
LEXINGTON MO
64067-1437
US

V. Phone/Fax

Practice location:
  • Phone: 660-259-3455
  • Fax: 660-259-2424
Mailing address:
  • Phone: 660-259-3455
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number2015029319
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: SETH ANATO
Title or Position: HEAD OF PHARMACY SERVICES
Credential: PHARMD
Phone: 618-463-0000