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BOLIVAR DRUG COMPOUNDING AND WELLNESS
NPI 1013021328
Pharmacy - Compounding Pharmacy in Bolivar, MO

Active since August 17, 2006
2000 S SPRINGFIELD AVE, BOLIVAR, MO 65613(417) 777-7455(417) 777-7455 Get Directions Write a Review

NPPES record last updated: October 26, 2013. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Bolivar Drug Compounding And Wellness NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BOLIVAR DRUG COMPOUNDING AND WELLNESS (NPI 1013021328) is a healthcare organization registered as a compounding pharmacy in Bolivar, Missouri and active in the NPI registry since August 2006. The organization lists Jeffrey Sparks, President, as its authorized official.

NPPES Registry Identity

NPI1013021328
Entity TypeOrganization
Primary Taxonomy3336C0004X
Legal Business NameSPARKS PHARMACY INC
Location Address2000 S SPRINGFIELD AVEBolivar, MO 65613-9654
Mailing AddressPo Box 33Bolivar, MO 65613-0033 · (417) 777-7455 · Fax (417) 777-7455
Phone(417) 777-7455
Fax(417) 777-7455
Organization SubpartNo
Authorized OfficialJeffrey SparksPresident · (417) 777-7455
Enumeration DateAugust 17, 2006
Last NPPES UpdateOctober 26, 2013
✔ NPI 1013021328 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPharmacy · Compounding PharmacySuppliers
Taxonomy Code3336C0004X
License✔ Licensed in MO · 005482
Definition
A pharmacy that specializes in the preparation of components into a drug preparation as the result of a Practitioner's Prescription Drug Order or initiative based on the Practitioner/Patient/Pharmacist relationship in the course of professional practice. A compounding pharmacy utilizes specialized equipment and specially designed facilities necessary to meet the legal and quality requirements of its scope of compounding practice.
Also ListedPharmacyTaxonomy 333600000X
2000 S SPRINGFIELD AVE, Bolivar, MO 65613
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Other Names 1

Doing Business AsBolivar Drug Compounding And Wellness

Other Identifiers 1

Other2137787Pk

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

GARY L RAE RPH
Pharmacist
2000 S SPRINGFIELD AVE
BOLIVAR, MO 65613
Polk County (417) 326-7455
KRISTI VANETTEN
Pharmacist
2000 S SPRINGFIELD AVE
BOLIVAR, MO 65613
Polk County (417) 325-7455

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Sparks Pharmacy Inc's NPI number?

The NPI number for Sparks Pharmacy Inc is 1013021328. It was assigned to this organization in the NPPES registry on August 17, 2006. The provider is doing business as Bolivar Drug Compounding And Wellness.

Where is Sparks Pharmacy Inc located?

Sparks Pharmacy Inc is located at 2000 S Springfield Ave, Bolivar, MO 65613. The listed phone number is (417) 777-7455.

What is Sparks Pharmacy Inc's specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Compounding Pharmacy, with taxonomy code 3336C0004X.

When was this NPI record last updated?

The NPPES record for Sparks Pharmacy Inc was last updated on October 26, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.