Healthcare Provider Details

I. General information

NPI: 1083155626
Provider Name (Legal Business Name): THE PHARMACY I LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/15/2017
Last Update Date: 12/17/2024
Certification Date: 12/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5492 HIGHWAY H UNIT E
PLEASANT HOPE MO
65725-8227
US

IV. Provider business mailing address

5492 HIGHWAY H UNIT E
PLEASANT HOPE MO
65725-8227
US

V. Phone/Fax

Practice location:
  • Phone: 417-267-6337
  • Fax: 417-267-2013
Mailing address:
  • Phone: 417-267-6337
  • Fax: 417-267-2013

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number2017004711
License Number StateMO
# 3
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: WHITNEY CHRISTOPHER GROVE
Title or Position: MANAGING MEMBER
Credential:
Phone: 417-267-6337