MEDICARE: TOLSON DRUG COMPANY, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336C0003X	Community/Retail Pharmacy
2	3336C0004X	Compounding Pharmacy
3	3336L0003X	Long Term Care Pharmacy
4	333600000X	Pharmacy	002467	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1174531347
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TOLSON DRUG COMPANY, INC.

Provider Business Mailing Address
First Line	:	P.O. BOX 1051
Second Line	:
City	:	JEFFERSON CITY
State	:	MO
Zip	:	65102-1051
Country	:	US
Telephone Number	:	573-636-4022
Fax Number	:	573-635-7687

Provider Business Practice Location Address
First Line	:	226 E. HIGH ST
Second Line	:
City	:	JEFFERSON CITY
State	:	MO
Zip	:	65101-1051
Country	:	US
Telephone Number	:	573-636-4022
Fax Number	:	573-635-7687

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. CAMERON T SCHULTE
Credential	:	PHARM.D.
Telephone Number	:	573-636-4022

Provider Enumeration Date	:	08/04/2006
Last Update Date	:	06/14/2022

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Directions to “TOLSON DRUG COMPANY, INC. ” Practice Location

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