Provider Demographics
NPI:1073522421
Name:LOGAN & SEILER INC
Entity Type:Organization
Organization Name:LOGAN & SEILER INC
Other - Org Name:L & S PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:LOGAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:573-683-3307
Mailing Address - Street 1:406 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:MO
Mailing Address - Zip Code:63834-1644
Mailing Address - Country:US
Mailing Address - Phone:573-683-3307
Mailing Address - Fax:573-683-3308
Practice Address - Street 1:406 S MAIN ST
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:MO
Practice Address - Zip Code:63834-1644
Practice Address - Country:US
Practice Address - Phone:573-683-3307
Practice Address - Fax:573-683-3308
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-05
Last Update Date:2016-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
MO0033503336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2048791OtherPK
MO600284004Medicaid
MO620284000Medicaid
MO620284000Medicaid