Provider Demographics
NPI:1336137108
Name:A & R PHARMACY II, INC.
Entity Type:Organization
Organization Name:A & R PHARMACY II, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:ASHTON
Authorized Official - Middle Name:T
Authorized Official - Last Name:STUTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:816-415-9995
Mailing Address - Street 1:445 E MILL ST
Mailing Address - Street 2:STE. A
Mailing Address - City:LIBERTY
Mailing Address - State:MO
Mailing Address - Zip Code:64068-1852
Mailing Address - Country:US
Mailing Address - Phone:816-415-9995
Mailing Address - Fax:816-415-4742
Practice Address - Street 1:445 E MILL ST
Practice Address - Street 2:
Practice Address - City:LIBERTY
Practice Address - State:MO
Practice Address - Zip Code:64068-1852
Practice Address - Country:US
Practice Address - Phone:816-415-9995
Practice Address - Fax:816-415-4742
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-06
Last Update Date:2014-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2003007191332B00000X
KS2202348333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO626145205Medicaid
MO626145205Medicaid
MO3938040001Medicare NSC