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General NPI Number Information
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NPI Number | 1497100887
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Entity Type | Organization
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Legal Business Name | PHARMAX PARTNERS INC
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Dates
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Enumeration Date | 05/04/2016
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Last Update Date | 01/26/2018
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Provider Practice Location Address
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Address Line | 116 WALNUT ST
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City | FESTUS
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State | MO
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Zip | 63028-1848
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Country | US
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Telephone | 636-937-7997
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Fax | 636-937-7998
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Provider Business Mailing Address
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Address Line | 116 WALNUT ST
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City | FESTUS
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State | MO
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Zip | 63028-1848
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Country | US
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Telephone | 636-937-7997
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Fax | 636-937-7998
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Authorized Official
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Title or Position | PRESIDENT
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Name | LARRY MCINTOSH
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Credential |
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Telephone | 314-954-5510
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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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 | 2016018376
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License Number State | MO
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