Provider Demographics
NPI:1134122740
Name:B P & W INC
Entity type:Organization
Organization Name:B P & W INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KOBY
Authorized Official - Middle Name:
Authorized Official - Last Name:PRATER
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:417-776-8701
Mailing Address - Street 1:PO BOX 280
Mailing Address - Street 2:
Mailing Address - City:SENECA
Mailing Address - State:MO
Mailing Address - Zip Code:64865-0280
Mailing Address - Country:US
Mailing Address - Phone:417-776-8701
Mailing Address - Fax:
Practice Address - Street 1:1711 CHEROKEE AVE
Practice Address - Street 2:
Practice Address - City:SENECA
Practice Address - State:MO
Practice Address - Zip Code:64865-8681
Practice Address - Country:US
Practice Address - Phone:417-776-8701
Practice Address - Fax:417-776-3974
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-05-27
Last Update Date:2020-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 333600000X, 3336L0003X
MO0049763336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO601091408Medicaid
OK100231940AMedicaid
2049892OtherPK
OK100231940AMedicaid