Provider Demographics
NPI:1013935279
Name:CANOTE PHARMACY, INC.
Entity Type:Organization
Organization Name:CANOTE PHARMACY, INC.
Other - Org Name:BRANSON DRUG MEDICAL PLAZA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST-IN-CHARGE, OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:BURNEY
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:417-332-0565
Mailing Address - Street 1:545 SKAGGS ROAD
Mailing Address - Street 2:SUITE 1007
Mailing Address - City:BRANSON
Mailing Address - State:MO
Mailing Address - Zip Code:65616
Mailing Address - Country:US
Mailing Address - Phone:417-332-0565
Mailing Address - Fax:417-332-0793
Practice Address - Street 1:545 SKAGGS ROAD
Practice Address - Street 2:SUITE 1007
Practice Address - City:BRANSON
Practice Address - State:MO
Practice Address - Zip Code:65616
Practice Address - Country:US
Practice Address - Phone:417-332-0565
Practice Address - Fax:417-332-0793
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20001576963336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy