Healthcare Provider Details

I. General information

NPI: 1578634580
Provider Name (Legal Business Name): RPCS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/13/2006
Last Update Date: 12/11/2021
Certification Date: 12/11/2021
Deactivation Date: 04/18/2018
Reactivation Date: 12/11/2021

III. Provider practice location address

5504 N 17TH ST
OZARK MO
65721-7489
US

IV. Provider business mailing address

1878 S STATE HWY 125
ROGERSVILLE MO
65742-8357
US

V. Phone/Fax

Practice location:
  • Phone: 417-581-9288
  • Fax: 417-582-0078
Mailing address:
  • Phone: 417-829-9281
  • Fax: 417-829-9204

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number2005003794
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MR. ERICK TAYLOR
Title or Position: C.E.O./PRESIDENT
Credential:
Phone: 417-829-9200