Provider Demographics
NPI:1215057005
Name:SINKS PHARMACY
Entity type:Organization
Organization Name:SINKS PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LOCAL HEALTH
Authorized Official - Middle Name:
Authorized Official - Last Name:MISSOURI INC
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:573-885-0885
Mailing Address - Street 1:PO BOX 528
Mailing Address - Street 2:
Mailing Address - City:CUBA
Mailing Address - State:MO
Mailing Address - Zip Code:65453-0528
Mailing Address - Country:US
Mailing Address - Phone:573-885-0885
Mailing Address - Fax:
Practice Address - Street 1:1375 E 10TH ST STE B
Practice Address - Street 2:
Practice Address - City:ROLLA
Practice Address - State:MO
Practice Address - Zip Code:65401-3591
Practice Address - Country:US
Practice Address - Phone:573-364-9616
Practice Address - Fax:573-341-3986
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-29
Last Update Date:2022-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2005000323332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies