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General NPI Number Information
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NPI Number | 1548349715
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Entity Type | Organization
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Legal Business Name | SEMO DRUGS OF KENNETT INC
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Dates
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Enumeration Date | 11/06/2006
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Last Update Date | 12/09/2021
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Provider Practice Location Address
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Address Line | 1300 1ST ST
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City | KENNETT
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State | MO
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Zip | 63857-2526
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Country | US
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Telephone | 573-888-8880
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Fax | 573-888-3889
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Provider Business Mailing Address
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Address Line | 1300 1ST ST
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City | KENNETT
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State | MO
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Zip | 63857-2526
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Country | US
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Telephone | 573-888-8880
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Fax | 573-888-3889
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Authorized Official
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Title or Position | PHARMACIST IN CHARGE
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Name | DR. JENNA HAWKINS
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Credential | PHARM D
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Telephone | 573-888-8880
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WD0400X
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Taxonomy Name | Diabetes Educator Registered Nurse
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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 | 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 #3
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 006018
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License Number State | MO
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