Healthcare Provider Details

I. General information

NPI: 1861038994
Provider Name (Legal Business Name): PARKLAND PHARMACY DEVELOPMENT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/25/2019
Last Update Date: 01/25/2025
Certification Date: 01/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

420 PIEDMONT AVE
PIEDMONT MO
63957-1024
US

IV. Provider business mailing address

1131 N DESLOGE DR
DESLOGE MO
63601-2936
US

V. Phone/Fax

Practice location:
  • Phone: 573-223-4235
  • Fax: 573-431-3833
Mailing address:
  • Phone: 573-431-6677
  • Fax: 573-431-3833

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: LISA KAY UMFLEET
Title or Position: OWNER
Credential: RPH
Phone: 573-431-6677