MEDICARE: MONARCH PHARMACY

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		MO

General Provider Information

NPI Number	:	1952774929
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MONARCH PHARMACY

Provider Business Mailing Address
First Line	:	1111 MILTARY AVE
Second Line	:
City	:	BAXTER SPRINGS
State	:	KS
Zip	:	66713-1509
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	11 S ORANGE ST
Second Line	:
City	:	BUTLER
State	:	MO
Zip	:	64730-1805
Country	:	US
Telephone Number	:	620-856-3030
Fax Number	:

Authorized Official
Title or Position	:	MANAGER/MEMBER
Name	:	KELLY BARNES
Credential	:	RPH
Telephone Number	:	620-856-3030

Provider Enumeration Date	:	11/12/2015
Last Update Date	:	09/22/2016

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Directions to “MONARCH PHARMACY ” Practice Location

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