Old Town Pharmacy LLC
NPI 1578754701 · Community/Retail Pharmacy · Monett, MO
Enrolled with Medicare as Part B Supplier - Mass Immunization (roster Biller Only) · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Old Town Pharmacy LLC is a Community/Retail Pharmacy organization in Monett, MO (NPI 1578754701).
Provider details
- NPI number
- 1578754701
- Entity type
- Organization
- Primary specialty
- Community/Retail PharmacySuppliers
- Organization subpart
- No
- Authorized official
- Shane Becker, Owner/Manager/Pic(417) 635-1100
- License
- 2007022497 (MO)
Specialties & taxonomies
Suppliers
Suppliers
- Long Term Care Pharmacy3336L0003X
Suppliers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure28% of score
18 yrs in NPPES registry
- Profile completeness28% of score
100% of core fields populated
- Practice footprint17% of score
1 documented practice location
- Medicare service volume (vs. specialty peers)28% of score
556 Medicare services, 2024 (ranked within specialty)
Medicare volume is ranked against active providers in the same specialty. Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
What this provider does (Medicare)
Based on Medicare fee-for-service claims, 2024; not all care is captured.
| Service (HCPCS) | Medicare services | Typical Medicare-allowed (2024) |
|---|---|---|
| Administration of Influenza Virus VaccineG0008 | 405 | $30 |
| Admn Sarscov2 Vacc 1 Dose90480 | 86 | $39 |
| Administration of Pneumococcal, Influenza, Hepatitis B, And/Or Covid-19 Vaccine Inside a Patient'S Home; Reported Only Once Per Individual Home Per Date of Service When Such Vaccine Administration(s) Are Performed at the Patient'S HomeM0201 | 65 | $35 |
Typical Medicare-allowed amounts for these services range $30–$39 (2024). The Medicare-allowed amount is what Medicare recognizes for a service under fee-for-service — a reference figure for 2024, not a price quote and not what you would be billed. Medicare Part B covers roughly an eighth of all NPIs (65+ skew); services with fewer than 11 beneficiaries are suppressed by CMS. Source: CMS Medicare Physician & Other Practitioners, by Provider & Service.
Practice location
Mailing address
Other names (DBA / former)
- Doing business as
- Old Town Pharmacy
Registry dates
- Enumerated
- 2007-08-05
- Last updated
- 2024-06-04
- Certified
- 2024-06-04
Frequently asked questions
- What is Old Town Pharmacy LLC's NPI number?
- Old Town Pharmacy LLC's National Provider Identifier (NPI) is 1578754701, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Old Town Pharmacy LLC?
- Old Town Pharmacy LLC is classified in the NPPES registry as Community/Retail Pharmacy (Suppliers).
- Where is Old Town Pharmacy LLC located?
- Old Town Pharmacy LLC's practice location on file with NPPES is 100a Chapel Drive, Monett, MO 65708.
- What is Old Town Pharmacy LLC's phone number?
- The practice phone number listed in the NPPES registry for Old Town Pharmacy LLC is (417) 635-1100.
- Does Old Town Pharmacy LLC accept Medicare?
- Old Town Pharmacy LLC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Old Town Pharmacy LLC?
- The authorized official listed on Old Town Pharmacy LLC's NPPES record is Shane Becker, Owner/Manager/Pic. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Old Town Pharmacy LLC's NPI active?
- Yes — Old Town Pharmacy LLC's NPI (1578754701) is active in the NPPES registry as of the last update on 2024-06-04.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.