OrganizationActive
State of Missouri
NPI 1750420188 · Long Term Care Pharmacy · Saint Joseph, MO
Provider details
- NPI number
- 1750420188
- Entity type
- Organization
- Primary specialty
- Long Term Care PharmacySuppliers
- Parent organization
- State of Missouri
- Organization subpart
- Yes
- Authorized official
- Molly Boeckmann, Director of Administrative Services(573) 751-4055
Specialties & taxonomies
Suppliers
Profile Score
Detailed profile(90/100 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
3505 Frederick Ave
Saint Joseph, MO 64506-2914
Phone: (816) 387-2564
Fax: (816) 387-2391
Street-level locationGet directions
Mailing address
1706 E Elm St
Jefferson City, MO 65101-4130
Other names (DBA / former)
- Doing business as
- Northwest Mo Prc Pharmacy
- Doing business as
- Northwest Mo Prc Pharmacy
Registry dates
- Enumerated
- 2007-02-05
- Last updated
- 2020-09-03
- Certified
- 2020-09-03
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.