Provider Demographics
NPI:1467592030
Name:RX SHOPS, INC
Entity Type:Organization
Organization Name:RX SHOPS, INC
Other - Org Name:GINGER'S HOMETOWN PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GINGER
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:417-532-9110
Mailing Address - Street 1:550 N JEFFERSON AVE
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:MO
Mailing Address - Zip Code:65536-2744
Mailing Address - Country:US
Mailing Address - Phone:417-532-9110
Mailing Address - Fax:417-532-9156
Practice Address - Street 1:550 N JEFFERSON AVE
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:MO
Practice Address - Zip Code:65536-2744
Practice Address - Country:US
Practice Address - Phone:417-532-9110
Practice Address - Fax:417-532-9156
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO043905332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO0903990001Medicare ID - Type Unspecified