OrganizationActive
Main Street Pharmacy LLC
NPI 1689700379 · Community/Retail Pharmacy · East Prairie, MO
Provider details
- NPI number
- 1689700379
- Entity type
- Organization
- Primary specialty
- Community/Retail PharmacySuppliers
- Organization subpart
- No
- Authorized official
- Tera Johnson, Manager(573) 649-9229
- License
- 2013000674 (MO)
Specialties & taxonomies
Suppliers
Profile Score
Detailed profile(89/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
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.
Practice location
117 E Main St
East Prairie, MO 63845-1136
Phone: (573) 649-9229
Fax: (573) 649-9230
Street-level locationGet directions
Mailing address
117 E Main St
East Prairie, MO 63845-1136
Other names (DBA / former)
- Doing business as
- Main Street Pharmacy
Registry dates
- Enumerated
- 2007-02-26
- Last updated
- 2015-02-09
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.