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BROADWAY PHARMACY LTC
NPI 1457758153
Pharmacy - Long Term Care Pharmacy in Cape Girardeau, MO

Active since November 24, 2014CLIA 26D2214267 · Waiver
37 DOCTORS PARK STE 7, CAPE GIRARDEAU, MO 63703(573) 803-2040 Get Directions Write a Review

NPPES record last updated: July 24, 2018. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Broadway Pharmacy Ltc NPPES

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

BROADWAY PHARMACY LTC (NPI 1457758153) is a healthcare organization registered as a long term care pharmacy in Cape Girardeau, Missouri and active in the NPI registry since November 2014. The organization holds a CLIA Waiver certificate valid through February 21, 2027 and lists Kevin Wood, Director Of Pharmacy, as its authorized official.

NPPES Registry Identity

NPI1457758153
Entity TypeOrganization
Primary Taxonomy3336L0003X
Legal Business NameBROADWAY LTC, LLC
Location Address37 DOCTORS PARK STE 7Cape Girardeau, MO 63703
Mailing Address710 Broadway StCape Girardeau, MO 63701-5514 · (573) 335-8207 · Fax (573) 335-4904
Phone(573) 803-2040
Organization SubpartNo
Authorized OfficialKevin WoodDirector Of Pharmacy · (573) 576-3029
Enumeration DateNovember 24, 2014
Last NPPES UpdateJuly 24, 2018
✔ NPI 1457758153 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPharmacy · Long Term Care PharmacySuppliers
Taxonomy Code3336L0003X
License✔ Licensed in MO · PS2014040344
Definition
A pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermediate care facilities, hospice, assisted living facilities, group homes, and other forms of congregate living arrangements.
37 DOCTORS PARK STE 7, Cape Girardeau, MO 63703
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Other Names 1

Doing Business AsBroadway Pharmacy Ltc

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 26D2214267

Broadway Ltc, LLC (dba - Broadway Ltc Pharmacy) · Cape Girardeau, MO
Active · expires Feb 21, 2027
CLIA Number26D2214267
Laboratory TypePharmacy
Certificate Effective DateFebruary 22, 2025
Certificate Expiration DateFebruary 21, 2027
Laboratory DirectorKevin Wood
Laboratory Phone(573) 803-2040
Laboratory LocationBroadway Ltc, LLC (dba - Broadway Ltc Pharmacy)37 Doctors Park Ste 7, Cape Girardeau, MO 63703
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 3

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Administration of pneumococcal, influenza, hepatitis b, and/or covid-19 vaccine inside a patient's home; reported only once per individual home per date of service when such vaccine administration(s) are performed at the patient's home M0201
The Covid-19 vaccine can be administered at your home for convenience and safety. This service is reported once per home, per date, when only the vaccine is given. It's a straightforward process where a medical professional visits your home to give the vaccine.
223 services181 patients
Administration of influenza virus vaccine G0008
The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.
21 services21 patients
Influenza vaccine, inactivated 90653
The Influenza vaccine, inactivated, is a shot given to protect against the flu. It contains killed virus particles that help your body build immunity to the flu. It's recommended annually to keep your protection up-to-date. It's safe for ages 6 months and up.
18 services18 patients

Other Providers at the Same Location NPPES

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

PARKVIEWRX MISSOURI, LLC
Pharmacy (Long Term Care Pharmacy)
37 DOCTORS PARK STE 7
CAPE GIRARDEAU, MO 63703
Cape Girardeau County (573) 803-2040

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 Broadway Ltc, LLC's NPI number?

The NPI number for Broadway Ltc, LLC is 1457758153. It was assigned to this organization in the NPPES registry on November 24, 2014. The provider is doing business as Broadway Pharmacy Ltc.

Where is Broadway Ltc, LLC located?

Broadway Ltc, LLC is located at 37 Doctors Park Ste 7, Cape Girardeau, MO 63703. The listed phone number is (573) 803-2040.

What is Broadway Ltc, LLC's specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Long Term Care Pharmacy, with taxonomy code 3336L0003X.

Does Broadway Ltc, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 26D2214267) is associated with this NPI, valid through February 21, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Broadway Ltc, LLC accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter Health of Delaware, Ambetter from Absolute Total Care and Ambetter from Arizona Complete Health and 40 other insurers list Broadway Ltc, 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 Broadway Ltc, LLC was last updated on July 24, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.