Provider Demographics
NPI:1932863867
Name:SWEET SPRINGS PHARMACY INC
Entity Type:Organization
Organization Name:SWEET SPRINGS PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:EUGENE
Authorized Official - Last Name:CLARK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:660-247-1580
Mailing Address - Street 1:PO BOX 737
Mailing Address - Street 2:
Mailing Address - City:CHILLICOTHE
Mailing Address - State:MO
Mailing Address - Zip Code:64601-0737
Mailing Address - Country:US
Mailing Address - Phone:660-247-1580
Mailing Address - Fax:660-707-0829
Practice Address - Street 1:807 E BROADWAY ST STE B
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:MO
Practice Address - Zip Code:65236-1468
Practice Address - Country:US
Practice Address - Phone:660-548-2118
Practice Address - Fax:660-548-2119
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SWEET SPRINGS PHARMACY INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-10-27
Last Update Date:2022-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy