KIRKSVILLE PHARMACY
NPI 1134579923
Pharmacy - Community/Retail Pharmacy in Kirksville, MO

Q: What is Kb Kirksville Pharmacy LLC's NPI number?

The NPI number for Kb Kirksville Pharmacy LLC is 1134579923. It was assigned to this organization in the NPPES registry on June 13, 2016. The provider is doing business as Kirksville Pharmacy.

Q: What is Kb Kirksville Pharmacy LLC's specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Community/Retail Pharmacy, with taxonomy code 3336C0003X.

Active since June 13, 2016CLIA 26D2121570 · Waiver

1611 S BALTIMORE ST, KIRKSVILLE, MO 63501(660) 956-7010(660) 956-7015 Get Directions Write a Review

NPPES record last updated: April 2, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Apr 2, 2020, Dec 18, 2016, Oct 17, 2016 and 5 more (8 updates tracked since 2016).

On this page

About Kirksville Pharmacy NPPES

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

KIRKSVILLE PHARMACY (NPI 1134579923) is a healthcare organization registered as a community/retail pharmacy in Kirksville, Missouri and active in the NPI registry since June 2016. The organization holds a CLIA Waiver certificate valid through November 7, 2026 and lists Tracy Timmermann, Manager/ao, as its authorized official.

NPPES Registry Identity

NPI1134579923

Entity TypeOrganization

Primary Taxonomy3336C0003X

Legal Business NameKB KIRKSVILLE PHARMACY LLC

Location Address1611 S BALTIMORE STKirksville, MO 63501-4518

Mailing Address1611 S Baltimore St, Ste BKirksville, MO 63501-4518 · (660) 956-7010 · Fax (660) 956-7015

Phone(660) 956-7010

Fax(660) 956-7015

Organization SubpartNo

Authorized OfficialTracy TimmermannManager/ao · (417) 876-3313

Enumeration DateJune 13, 2016

Last NPPES UpdateApril 2, 20208 updates tracked since enumeration

NPPES CertifiedApril 2, 2020

✔ NPI 1134579923 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers

Taxonomy Code3336C0003X

License✔ Licensed in MO · 2016029935

Definition

A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.

Also ListedPharmacyTaxonomy 333600000X

Also ListedPharmacy · Compounding PharmacyTaxonomy 3336C0004X

Also ListedPharmacy · Long Term Care PharmacyTaxonomy 3336L0003X

1611 S BALTIMORE ST, Kirksville, MO 63501

Open in Google Maps ↗

Other Names 1

Doing Business AsKirksville Pharmacy

Other Identifiers 2

Medicaid600035560MO

Other2160612Pk

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter from Arizona Complete Health and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 26D2121570

Kb Kirksville Pharmacy LLC · Kirksville, MO

Active · expires Nov 7, 2026

CLIA Number26D2121570

Laboratory TypePharmacy

Certificate Effective DateNovember 8, 2024

Certificate Expiration DateNovember 7, 2026

Laboratory DirectorBlanck L. Levi

Laboratory Phone(660) 956-7010

Laboratory LocationKb Kirksville Pharmacy LLC1611 S Baltimore Suite B, Kirksville, MO 63501

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Medical Equipment Supplier Medicare DMEPOS 4

Medicare supplier enrollment and the product categories Kb Kirksville Pharmacy, LLC carries, from the Medicare DMEPOS supplier directory.

Kb Kirksville Pharmacy, LLC

DMEPOS supplier · Kirksville, MO

⋮

Does not accept Medicare assignment

Kb Kirksville Pharmacy, LLC has not agreed to accept the Medicare-approved amount as full payment for covered equipment and supplies. Medicare patients may be charged more than the Medicare-approved amount; confirm the expected cost with the supplier before ordering.

PTAN (Medicare Supplier Number)20477237

Medicare Participant SinceAugust 1, 2016

Supplier Location1611 S Baltimore StKirksville, MO 63501

Phone(660) 956-7010

Supplier Specialties

Pharmacy

Medicare Product Categories

Immunosuppressive Drugs

Immunosuppressive drugs require dosage, frequency, and route of administration to prevent or treat the rejection of an organ transplant

Nebulizer Drugs

Albuterol, levalbuterol, and metaproterenol are all short-acting bronchodilators with beta-adrenergic stimulatory effect

Oral Anticancer Drugs

FDA anticancer drugs

Blood Glucose Monitors/Supplies (Non-Mail Order)

Home blood glucose monitors including lancets, reagent strips, and other supplies necessary for the proper functioning of the device

Product categories are from the Medicare DMEPOS supplier directory. Contact the supplier to confirm current availability of specific items.

Leave this field empty

Other Providers at the Same Location NPPES 17

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

BROOKE APRIL SPRAGUE FNP-C

Nurse Practitioner (Family)