OLD TOWN PHARMACY
NPI 1164976999
Pharmacy in Pierce City, MO
NPI Status: Active since August 10, 2016
Contact Information
119 E MAIN ST
PIERCE CITY, MO
ZIP 65723
Phone: (417) 476-2828
Fax: (417) 476-5198
- Organization
- Pharmacy
- Accepts Insurance
- CLIA Number: 26D2152451
- CLIA Cert. Type: Pharmacy
- CLIA Exp. Date: 08-08-2026
About OLD TOWN PHARMACY
This page provides the complete NPI Profile along with additional information for Old Town Pharmacy, a provider established in Pierce City, Missouri operating as a Pharmacy. The healthcare provider is registered in the NPI registry with number 1164976999 assigned on August 2016. The practitioner's primary taxonomy code is 333600000X with license number 2016027850 (MO). The provider is registered as an organization and their NPI record was last updated 10 years ago. The provider's is doing business as Old Town Pharmacy. The authorized official of this NPI record is Shane Becker (Owner)
- NPI
- 1164976999
- Provider Legal Name
- OLD TOWN PHARMACY NUMBER 2 LLC
- Other Organization Name
- OLD TOWN PHARMACY
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 119 E MAIN ST PIERCE CITY, MO 65723
- Location Phone
- (417) 476-2828
- Location Fax
- (417) 476-5198
- Mailing Address
- 119 E MAIN ST PIERCE CITY, MO 65723
- Mailing Phone
- (417) 476-2828
- Mailing Fax
- (417) 476-5198
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 08-10-2016
- Last Update Date
- 08-31-2016
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Pharmacy
- Taxonomy Code
- 333600000X
- Type
- Suppliers
- License No.
- 2016027850
- License State
- MO
- Taxonomy Description
- 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.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 3336C0003X | Suppliers | Pharmacy | |
| 2 | 3336L0003X | Suppliers | Pharmacy |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Balance by Medica Bronze $0 Copay PCP Visits - EPO
- Balance by Medica Bronze $0 Copay PCP Visits - PPO
- Balance by Medica Bronze Premier - EPO
- Balance by Medica Bronze Premier - PPO
- Balance by Medica Expanded Bronze Standard - EPO
- Balance by Medica Expanded Bronze Standard - PPO
- Balance by Medica Gold $0 Copay PCP Visits - EPO
- Balance by Medica Gold $0 Copay PCP Visits - PPO
- Balance by Medica Gold Share - EPO
- Balance by Medica Gold Share - PPO
- Balance by Medica Gold Standard - EPO
- Balance by Medica Gold Standard - PPO
- Balance by Medica Silver $0 Copay PCP Visits - EPO
- Balance by Medica Silver $0 Copay PCP Visits - PPO
- Balance by Medica Silver Share - EPO
- Balance by Medica Silver Share - PPO
- Balance by Medica Silver Standard - EPO
- Balance by Medica Silver Standard - PPO
- Elevate by Medica Bronze $0 Copay PCP Visits - EPO
- Elevate by Medica Bronze Premier - EPO
- Moda Health Affinity Bronze 8000 - EPO
- Moda Health Affinity Bronze 9000 - EPO
- Moda Health Affinity Bronze HDHP 7500 - EPO
- Moda Health Affinity Gold 1000 - EPO
- Moda Health Affinity Gold 1500 - EPO
- Moda Health Affinity Gold 250 - EPO
- Moda Health Affinity Silver 3000 - EPO
- Moda Health Affinity Silver 3400 - EPO
- Moda Health Affinity Silver 4500 - EPO
- Moda Health Affinity Silver 6000 - EPO
- Moda Health Oregon Standard Bronze Affinity - EPO
- Moda Health Oregon Standard Gold Affinity - EPO
- Moda Health Oregon Standard Silver Affinity - EPO
- Moda Select Alaska Bronze 6500 - PPO
- Moda Select Alaska Bronze HDHP 5500 - PPO
- Moda Select Alaska Gold 1500 - PPO
- Moda Select Alaska Silver 4500 - PPO
- Moda Select Alaska Standard Bronze - PPO
- Moda Select Alaska Standard Gold - PPO
- Moda Select Alaska Standard Silver - PPO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 2162359 | OTHER (01) | PK |
Areas of Expertise
The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.
Provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared, one test count
This service provides a FDA-approved COVID-19 test kit for personal use. The test is self-administered and self-collected, meaning you conduct the test yourself. The kit contains all necessary items for one test. Follow the instructions carefully to ensure accurate results.
This service was performed 96 times for 12 patientsCLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 26D2152451
- Facility Type
- Pharmacy
- Certificate Effective Date
- August 09, 2024
- Certificate Expiration Date
- August 08, 2026
- Laboratory Director
- REBECCA J. BECKER
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Old Town Pharmacy to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
Reviews for OLD TOWN PHARMACY
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1164976999, we treat the final digit (9) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 71. The final step is to find the difference between that total and the next multiple of ten (80 - 71 = 9).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 71 is 80. The difference is the calculated check digit.
Other Providers at the Same Location
The following 3 providers are registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1164976999, enumerated as an "organization" on August 10, 2016.
The provider is located at 119 E MAIN ST PIERCE CITY, MO 65723 and the phone number is (417) 476-2828.
Pharmacy with taxonomy code 333600000X.
The provider might be accepting Accepts: Medica, Moda Health Plan, Inc., Medicare and. Please consult your insurance carrier or call the provider to verify.
