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General NPI Number Information
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NPI Number | 1912082538
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Entity Type | Organization
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Legal Business Name | JUSTBREN, INC.
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Dates
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Enumeration Date | 10/25/2006
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Last Update Date | 03/11/2026
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Provider Practice Location Address
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Address Line | 1101 W MONROE ST STE 103
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City | MEXICO
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State | MO
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Zip | 65265-1977
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Country | US
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Telephone | 573-581-7561
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Fax | 573-581-7562
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Provider Business Mailing Address
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Address Line | 1101 W MONROE ST STE 103
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City | MEXICO
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State | MO
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Zip | 65265-1977
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Country | US
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Telephone | 573-581-7561
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Fax | 573-581-7562
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Authorized Official
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Title or Position | OWNER
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Name | MR. LARRY WEBBER
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Credential | RPH
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Telephone | 573-581-7561
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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 | 15496147
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License Number State | MO
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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 |
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License Number State | MO
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