Provider Demographics
NPI:1386655322
Name:TONEYS DRUG & WELLNESS, LLC
Entity Type:Organization
Organization Name:TONEYS DRUG & WELLNESS, LLC
Other - Org Name:PIEDMONT FAMILY PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:JENNY
Authorized Official - Middle Name:
Authorized Official - Last Name:TONEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:573-223-4823
Mailing Address - Street 1:PO BOX 157
Mailing Address - Street 2:
Mailing Address - City:PIEDMONT
Mailing Address - State:MO
Mailing Address - Zip Code:63957
Mailing Address - Country:US
Mailing Address - Phone:573-223-4823
Mailing Address - Fax:573-223-2665
Practice Address - Street 1:1 HAL'S PLAZA DRIVE
Practice Address - Street 2:
Practice Address - City:PIEDMONT
Practice Address - State:MO
Practice Address - Zip Code:63957
Practice Address - Country:US
Practice Address - Phone:573-223-4823
Practice Address - Fax:573-223-4823
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-11
Last Update Date:2020-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336L0003X
MO20040035493336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO600242507Medicaid
2047237OtherPK
MO600242507Medicaid