Provider Demographics
NPI:1609206721
Name:MEDICAL DEVELOPMENTS, INC.
Entity Type:Organization
Organization Name:MEDICAL DEVELOPMENTS, INC.
Other - Org Name:CONVENIENT CARE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACY MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:LEROY
Authorized Official - Last Name:BRIGHT
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:417-335-7700
Mailing Address - Street 1:525 BRANSON LANDING BLVD
Mailing Address - Street 2:SUITE 1005
Mailing Address - City:BRANSON
Mailing Address - State:MO
Mailing Address - Zip Code:65616-2052
Mailing Address - Country:US
Mailing Address - Phone:417-335-7000
Mailing Address - Fax:417-335-7003
Practice Address - Street 1:525 BRANSON LANDING BLVD
Practice Address - Street 2:SUITE 1005
Practice Address - City:BRANSON
Practice Address - State:MO
Practice Address - Zip Code:65616-2052
Practice Address - Country:US
Practice Address - Phone:417-269-7470
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MEDICAL DEVELOPMENTS INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-11-27
Last Update Date:2019-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20130428293336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO7305420001Medicare NSC