Provider Demographics
NPI:1558781278
Name:FLOW'S PHARMACY, INC
Entity Type:Organization
Organization Name:FLOW'S PHARMACY, INC
Other - Org Name:FLOW'S PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SECRETARY/TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:RANDAL
Authorized Official - Last Name:FLOW
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:573-826-1236
Mailing Address - Street 1:303 N KEENE ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65201-7193
Mailing Address - Country:US
Mailing Address - Phone:573-447-8093
Mailing Address - Fax:573-447-8095
Practice Address - Street 1:303 N KEENE ST
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65201-7193
Practice Address - Country:US
Practice Address - Phone:573-447-8093
Practice Address - Fax:573-447-8095
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-21
Last Update Date:2014-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20140120013336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO2014012001OtherBOARD OF PHARMACY
MO2500020655OtherBNDD