Healthcare Provider Details

I. General information

NPI: 1407958598
Provider Name (Legal Business Name): BEST BUY PHARMACY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/01/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3430 GEORGIA ST
LOUISIANA MO
63353-2744
US

IV. Provider business mailing address

3430 GEORGIA ST
LOUISIANA MO
63353-2744
US

V. Phone/Fax

Practice location:
  • Phone: 573-754-6233
  • Fax: 573-754-4028
Mailing address:
  • Phone: 573-754-6233
  • Fax: 573-754-4028

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number006301
License Number StateMO

VIII. Authorized Official

Name: MR. JEFFREY C BARNES
Title or Position: PRESIDENT
Credential: R.PH.
Phone: 573-754-6233