Provider Demographics
NPI:1528375508
Name:MISSOURI PHARMACIST CARE NETWORK, LLC
Entity Type:Organization
Organization Name:MISSOURI PHARMACIST CARE NETWORK, LLC
Other - Org Name:MOPCN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RON
Authorized Official - Middle Name:
Authorized Official - Last Name:FITZWATER
Authorized Official - Suffix:
Authorized Official - Credentials:CAE
Authorized Official - Phone:573-636-7522
Mailing Address - Street 1:211 E CAPITOL AVE
Mailing Address - Street 2:
Mailing Address - City:JEFFERSON CITY
Mailing Address - State:MO
Mailing Address - Zip Code:65101-3001
Mailing Address - Country:US
Mailing Address - Phone:573-636-7522
Mailing Address - Fax:573-636-7485
Practice Address - Street 1:211 E CAPITOL AVE
Practice Address - Street 2:
Practice Address - City:JEFFERSON CITY
Practice Address - State:MO
Practice Address - Zip Code:65101-3001
Practice Address - Country:US
Practice Address - Phone:573-636-7522
Practice Address - Fax:573-636-7485
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MISSOURI PHARMACY ASSOCIATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-09-11
Last Update Date:2010-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacyGroup - Single Specialty