Provider Demographics
NPI:1861038994
Name:PARKLAND PHARMACY DEVELOPMENT LLC
Entity Type:Organization
Organization Name:PARKLAND PHARMACY DEVELOPMENT LLC
Other - Org Name:PARKLAND HEALTH MART PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:UMFLEET
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:573-431-6677
Mailing Address - Street 1:1131 N DESLOGE DR
Mailing Address - Street 2:
Mailing Address - City:DESLOGE
Mailing Address - State:MO
Mailing Address - Zip Code:63601-2936
Mailing Address - Country:US
Mailing Address - Phone:573-431-6677
Mailing Address - Fax:573-431-3833
Practice Address - Street 1:420 PIEDMONT AVE
Practice Address - Street 2:
Practice Address - City:PIEDMONT
Practice Address - State:MO
Practice Address - Zip Code:63957-1024
Practice Address - Country:US
Practice Address - Phone:573-223-4235
Practice Address - Fax:573-431-3833
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PARKLAND PHARMACY DEVELOPMENT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-11-25
Last Update Date:2020-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies