Provider Demographics
NPI:1194806703
Name:CITY PHARMACY INC.
Entity type:Organization
Organization Name:CITY PHARMACY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:MARKOVICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:660-529-2255
Mailing Address - Street 1:229 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SLATER
Mailing Address - State:MO
Mailing Address - Zip Code:65349-1411
Mailing Address - Country:US
Mailing Address - Phone:660-529-2255
Mailing Address - Fax:660-529-2701
Practice Address - Street 1:229 MAIN ST
Practice Address - Street 2:
Practice Address - City:SLATER
Practice Address - State:MO
Practice Address - Zip Code:65349-1411
Practice Address - Country:US
Practice Address - Phone:660-529-2255
Practice Address - Fax:660-529-2701
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOPS0039193336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy