| NPI | 1275084865 |
|---|---|
| NPI Type | NPI-2 Organization |
| Status | Active |
| Enumeration Date | 2016-10-18 |
| Last Updated | 2025-09-19 |
| Authorized Official | Abraham Funk Owner Phone: 5737850984 |
| Mailing Address | 2007 Independence St Cape Girardeau, MO 63703-5805 United States Phone: (573) 785-0984 | Fax: (573) 785-2257 📍 View Map |
| Primary Practice Address | 909 W Pine St Poplar Bluff, MO 63901-4958 United States Phone: (573) 785-0984 | Fax: (573) 785-2257 📍 View Map |
| Issuer | State | Number | Other Issuer |
|---|---|---|---|
| Other (non-Medicare) | - | 2166615 | PK |
| MEDICAID | MO | 600059703 | - |
| Primary | Taxonomy Code & Description | State | License Number |
|---|---|---|---|
| No | 333600000X – Pharmacy | - | - |
| No | 3336C0004X – Pharmacy, Compounding Pharmacy | - | - |
| No | 3336L0003X – Pharmacy, Long Term Care Pharmacy | - | - |
| Yes | 3336C0003X – Pharmacy, Community/Retail Pharmacy | MO | 2016042382 |
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About NPI 1275084865
Poplar Bluff Pharmacy Llc is an organization registered in the CMS NPPES NPI Registry with NPI number 1275084865. The primary specialty listed is Pharmacy, Community/Retail Pharmacy. The organization is located in Poplar Bluff, MO. This NPI is classified as a Type 2 (Organizational) NPI and is currently active. The NPI was first enumerated (assigned) on 2016-10-18. All data is sourced directly from the official CMS NPPES public API and is updated daily.
Frequently Asked Questions
What is NPI 1275084865?
NPI 1275084865 belongs to Poplar Bluff Pharmacy Llc, a Pharmacy, Community/Retail Pharmacy in Poplar Bluff, MO. It is a Type 2 Organizational NPI registered in the CMS NPPES NPI Registry.
Is NPI 1275084865 active?
The current status of NPI 1275084865 in the NPPES registry is Active. The record was last updated on 2025-09-19.
What specialty is NPI 1275084865?
NPI 1275084865 is classified under the taxonomy Pharmacy, Community/Retail Pharmacy. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.
How do I verify NPI 1275084865?
You can verify NPI 1275084865 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.
What address is on file for NPI 1275084865?
The primary practice address on file for NPI 1275084865 is 909 W Pine St, Poplar Bluff, MO 63901-4958. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.
When was NPI 1275084865 issued?
NPI 1275084865 was first issued (enumerated) on 2016-10-18. The NPPES record was last updated on 2025-09-19.
Practice Location Map
Poplar Bluff Pharmacy Llc is located at 909 W Pine St, Poplar Bluff, MO. Use the map below to find directions or verify the practice location.
Related Healthcare Providers
The following providers share the same practice location, specialty, or state as Poplar Bluff Pharmacy Llc. All records sourced from the CMS NPPES registry.
License Information
The following state license numbers are on file in the NPPES registry for NPI 1275084865. For license status verification, contact the relevant state licensing board directly.
| Specialty / Taxonomy | License Number | State |
|---|---|---|
| Pharmacy, Community/Retail Pharmacy | 2016042382 | MO |