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 |
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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 |
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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 |
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Provider Enumeration Date | 05/29/2024 |
Last Update Date | 05/29/2024 |
Identifier | Type | State | Issuer |
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1255171039 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | (* (Not Available)) | Primary |