Provider Demographics
NPI:1891117933
Name:SWEET SPRINGS PHARMACY INC
Entity Type:Organization
Organization Name:SWEET SPRINGS PHARMACY INC
Other - Org Name:CAMERON FAMILY PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST-IN-CHARGE
Authorized Official - Prefix:
Authorized Official - First Name:JILL
Authorized Official - Middle Name:
Authorized Official - Last Name:SAUNDERS
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:816-592-1102
Mailing Address - Street 1:1303 N WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:CAMERON
Mailing Address - State:MO
Mailing Address - Zip Code:64429-1326
Mailing Address - Country:US
Mailing Address - Phone:816-632-2201
Mailing Address - Fax:816-632-4237
Practice Address - Street 1:1303 N WALNUT ST
Practice Address - Street 2:
Practice Address - City:CAMERON
Practice Address - State:MO
Practice Address - Zip Code:64429-1326
Practice Address - Country:US
Practice Address - Phone:816-632-2201
Practice Address - Fax:816-632-4237
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-08
Last Update Date:2021-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1891117933Medicaid