Provider Demographics
NPI:1407958598
Name:BEST BUY PHARMACY
Entity type:Organization
Organization Name:BEST BUY PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:C
Authorized Official - Last Name:BARNES
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:573-754-6233
Mailing Address - Street 1:3430 GEORGIA ST
Mailing Address - Street 2:
Mailing Address - City:LOUISIANA
Mailing Address - State:MO
Mailing Address - Zip Code:63353-2744
Mailing Address - Country:US
Mailing Address - Phone:573-754-6233
Mailing Address - Fax:573-754-4028
Practice Address - Street 1:3430 GEORGIA ST
Practice Address - Street 2:
Practice Address - City:LOUISIANA
Practice Address - State:MO
Practice Address - Zip Code:63353-2744
Practice Address - Country:US
Practice Address - Phone:573-754-6233
Practice Address - Fax:573-754-4028
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO0063013336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL=========001Medicaid
IL=========001Medicaid