Provider Demographics
NPI:1831716372
Name:ANDLEE, LLC
Entity type:Organization
Organization Name:ANDLEE, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHARMACIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:A
Authorized Official - Last Name:DODGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:660-327-4514
Mailing Address - Street 1:865 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:PARIS
Mailing Address - State:MO
Mailing Address - Zip Code:65275-1178
Mailing Address - Country:US
Mailing Address - Phone:660-327-4514
Mailing Address - Fax:
Practice Address - Street 1:865 S MAIN ST
Practice Address - Street 2:
Practice Address - City:PARIS
Practice Address - State:MO
Practice Address - Zip Code:65275-1178
Practice Address - Country:US
Practice Address - Phone:660-327-4514
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ANDLEE, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-07-01
Last Update Date:2025-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy