Provider Demographics
NPI:1194302208
Name:PHARMINGTONRX, LLC
Entity type:Organization
Organization Name:PHARMINGTONRX, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:HAMBY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:573-431-6677
Mailing Address - Street 1:806 VALLEY CREEK DR
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:MO
Mailing Address - Zip Code:63640-1969
Mailing Address - Country:US
Mailing Address - Phone:573-747-1191
Mailing Address - Fax:573-747-1191
Practice Address - Street 1:806 VALLEY CREEK DR
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:MO
Practice Address - Zip Code:63640-1969
Practice Address - Country:US
Practice Address - Phone:573-747-1191
Practice Address - Fax:573-747-1191
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-25
Last Update Date:2025-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO600050517Medicaid