Provider Demographics
NPI:1922737964
Name:OZARK SPECIALTY PHARMACY AND HOME INFUSION, LLC
Entity Type:Organization
Organization Name:OZARK SPECIALTY PHARMACY AND HOME INFUSION, LLC
Other - Org Name:OZARK PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHERI
Authorized Official - Middle Name:
Authorized Official - Last Name:BARTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:738-724-2195
Mailing Address - Street 1:2725 N WESTWOOD BLVD STE 1A
Mailing Address - Street 2:
Mailing Address - City:POPLAR BLUFF
Mailing Address - State:MO
Mailing Address - Zip Code:63901-2367
Mailing Address - Country:US
Mailing Address - Phone:573-772-5800
Mailing Address - Fax:573-287-3535
Practice Address - Street 1:2725 N WESTWOOD BLVD STE 1A
Practice Address - Street 2:
Practice Address - City:POPLAR BLUFF
Practice Address - State:MO
Practice Address - Zip Code:63901-2367
Practice Address - Country:US
Practice Address - Phone:573-772-5800
Practice Address - Fax:573-287-3535
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-06
Last Update Date:2023-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy