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General NPI Number Information
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NPI Number | 1366704876
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Entity Type | Organization
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Legal Business Name | PARKLAND PHARMACY DEVELOPMENT LLC
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Dates
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Enumeration Date | 06/11/2012
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Last Update Date | 01/25/2025
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Provider Practice Location Address
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Address Line | 1025 E HIGHWAY 72 BYP
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City | FREDERICKTOWN
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State | MO
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Zip | 63645-7326
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Country | US
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Telephone | 573-783-6000
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Fax | 573-783-6008
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Provider Business Mailing Address
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Address Line | 1025 E HIGHWAY 72 BYP
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City | FREDERICKTOWN
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State | MO
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Zip | 63645-7326
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Country | US
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Telephone | 573-783-6000
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Fax | 573-783-6008
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Authorized Official
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Title or Position | OWNER
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Name | JEREMY LEACH
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Credential | RPH
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Telephone | 573-783-6000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 2012034351
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License Number State | MO
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