Provider Demographics
NPI:1962245712
Name:FORBES PHARMACY LLC
Entity type:Organization
Organization Name:FORBES PHARMACY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JEREMY
Authorized Official - Middle Name:
Authorized Official - Last Name:RINNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:417-350-4619
Mailing Address - Street 1:PO BOX 495
Mailing Address - Street 2:
Mailing Address - City:LICKING
Mailing Address - State:MO
Mailing Address - Zip Code:65542-0495
Mailing Address - Country:US
Mailing Address - Phone:573-674-2995
Mailing Address - Fax:573-674-2995
Practice Address - Street 1:100 N GRAND AVE
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:MO
Practice Address - Zip Code:65483-1222
Practice Address - Country:US
Practice Address - Phone:417-318-0330
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-18
Last Update Date:2024-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy