1. Home
  2. Directory
  3. Missouri
  4. Pierce City
  5. Pharmacy
  6. NPI Profile

OLD TOWN PHARMACY
NPI 1164976999
Pharmacy in Pierce City, MO

Active since August 10, 2016
119 E MAIN ST, PIERCE CITY, MO 65723(417) 476-2828(417) 476-5198 Get Directions Write a Review

NPPES record last updated: August 31, 2016. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Aug 31, 2016, Aug 10, 2016 (2 updates tracked since 2016).

About Old Town Pharmacy NPPES

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

OLD TOWN PHARMACY (NPI 1164976999) is a healthcare organization registered as a pharmacy in Pierce City, Missouri and active in the NPI registry since August 2016. The organization lists Shane Becker, Owner, as its authorized official.

NPPES Registry Identity

NPI1164976999
Entity TypeOrganization
Primary Taxonomy333600000X
Legal Business NameOLD TOWN PHARMACY NUMBER 2 LLC
Location Address119 E MAIN STPierce City, MO 65723-1228
Mailing Address119 E Main StPierce City, MO 65723-1228 · (417) 476-2828 · Fax (417) 476-5198
Phone(417) 476-2828
Fax(417) 476-5198
Organization SubpartNo
Authorized OfficialShane BeckerOwner · (417) 476-2828
Enumeration DateAugust 10, 2016
Last NPPES UpdateAugust 31, 20162 updates tracked since enumeration
✔ NPI 1164976999 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPharmacySuppliers
Taxonomy Code333600000X
License✔ Licensed in MO · 2016027850
Definition
A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.
Also ListedPharmacy · Community/Retail PharmacyTaxonomy 3336C0003X
Also ListedPharmacy · Long Term Care PharmacyTaxonomy 3336L0003X
119 E MAIN ST, Pierce City, MO 65723
Open in Google Maps ↗

Other Names 1

Doing Business AsOld Town Pharmacy

Other Identifiers 1

Other2162359Pk

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Medica, Moda Health Plan, Inc..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 26D2152451

Old Town Pharmacy #2 LLC · Pierce City, MO
Expired · Aug 8, 2026
CLIA Number26D2152451
Laboratory TypePharmacy
Certificate Effective DateAugust 9, 2024
Certificate Expiration DateAugust 8, 2026
Laboratory DirectorRebecca J. Becker
Laboratory Phone(417) 476-2828
Laboratory LocationOld Town Pharmacy #2 LLC119 E Main Street, Pierce City, MO 65723
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 3

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

RAYMOND KIRK
Pharmacist
119 E MAIN ST
PIERCE CITY, MO 65723
Lawrence County (417) 476-2828
LLOYD WARNER RPH
Pharmacist
119 E MAIN ST
PIERCE CITY, MO 65723
Lawrence County (417) 476-2828
THOMPSON FAMILY DRUG
Pharmacy (Community/Retail Pharmacy)
119 E MAIN ST
PIERCE CITY, MO 65723
Lawrence County (417) 476-2828

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 Old Town Pharmacy Number 2 LLC's NPI number?

The NPI number for Old Town Pharmacy Number 2 LLC is 1164976999. It was assigned to this organization in the NPPES registry on August 10, 2016. The provider is doing business as Old Town Pharmacy.

Where is Old Town Pharmacy Number 2 LLC located?

Old Town Pharmacy Number 2 LLC is located at 119 E Main St, Pierce City, MO 65723. The listed phone number is (417) 476-2828.

What is Old Town Pharmacy Number 2 LLC's specialty?

The primary specialty registered for this NPI is Pharmacy with taxonomy code 333600000X.

What insurance does Old Town Pharmacy Number 2 LLC accept?

Health plans from Medica and Moda Health Plan, Inc. list Old Town Pharmacy Number 2 LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Old Town Pharmacy Number 2 LLC was last updated on August 31, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.