| Hines Street Pharmacy 2 Llc | |
|
201 S Highway 60 Marionville MO 65705-9407 | |
| (417) 735-0055 | |
| Not Available |
| Full Name | Hines Street Pharmacy 2 Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 201 S Highway 60, Marionville, Missouri |
| Authorized Official Name and Position | Stephen L Mcclanahan (OWNER) |
| Authorized Official Contact | 4177350055 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Hines Street Pharmacy 2 Llc 1173 E Hines St Republic MO 65738-1277 Ph: () - | Hines Street Pharmacy 2 Llc 201 S Highway 60 Marionville MO 65705-9407 Ph: (417) 735-0055 |
| NPI Number | 1255171039 |
|---|---|
| Provider Enumeration Date | 05/29/2024 |
| Last Update Date | 05/29/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255171039 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |