Provider Demographics
NPI:1235124652
Name:TOWN & COUNTRY PHARMACIES, INC, D/B/A THRIFTWAY DRUGS
Entity Type:Organization
Organization Name:TOWN & COUNTRY PHARMACIES, INC, D/B/A THRIFTWAY DRUGS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACY MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KELLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:PIPKIN
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:573-243-3117
Mailing Address - Street 1:404 S HOPE ST
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MO
Mailing Address - Zip Code:63755-2133
Mailing Address - Country:US
Mailing Address - Phone:573-243-3117
Mailing Address - Fax:573-243-3118
Practice Address - Street 1:404 S HOPE ST
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MO
Practice Address - Zip Code:63755-2133
Practice Address - Country:US
Practice Address - Phone:573-243-3117
Practice Address - Fax:573-243-3118
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO043398183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO4803990003Medicare ID - Type Unspecified
MO2615928Medicare UPIN