Healthcare Provider Details

I. General information

NPI: 1083098263
Provider Name (Legal Business Name): TOP NOTCH PHARMACIES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2015
Last Update Date: 03/13/2020
Certification Date: 03/13/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1412 HIGH ST
SARCOXIE MO
64862
US

IV. Provider business mailing address

PO BOX 625
SARCOXIE MO
64862-0625
US

V. Phone/Fax

Practice location:
  • Phone: 417-548-7184
  • Fax: 417-548-7404
Mailing address:
  • Phone: 417-548-7184
  • Fax: 417-548-7404

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 Number2015029947
License Number StateMO
# 3
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: KOBY PRATER
Title or Position: MANAGING MEMBER
Credential:
Phone: 417-592-7381