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NPI 1679314272

NPI 1679314272 : TKM PHARMACY, LLC : GARDEN CITY, MO

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General NPI Number Information
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    NPI Number           |    1679314272
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    Entity Type          |    Organization 
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    Legal Business Name  |    TKM PHARMACY, LLC 
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Dates
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    Enumeration Date     |    06/05/2024
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    Last Update Date     |    06/05/2024
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Provider Practice Location Address
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    Address Line         |    202 OLD HIGHWAY 7 RD 
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    City                 |    GARDEN CITY
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    State                |    MO
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    Zip                  |    64747-8182
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    Country              |    US
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    Telephone            |    816-755-3070
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    202 OLD HIGHWAY 7 RD 
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    City                 |    GARDEN CITY
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    State                |    MO
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    Zip                  |    64747-8182
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    Country              |    US
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    Telephone            |    816-755-3070
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    Fax                  |    
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Authorized Official
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    Title or Position    |    MANAGER
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    Name                 |     TAYLOR  MIZE 
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    Credential           |    PHARMD
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    Telephone            |    573-217-9404
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    3336C0003X
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    Taxonomy Name        |    Community/Retail Pharmacy
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    License Number       |    
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    License Number State |    
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