1. Home
  2. Directory
  3. Missouri
  4. Saint Louis
  5. Pharmacy
  6. NPI Profile

MISSOURI MED LLC
NPI 1477412963
Pharmacy - Long Term Care Pharmacy in Saint Louis, MO

Active since January 20, 2026
11643 LILBURN PARK RD, SAINT LOUIS, MO 63146(314) 445-2900 Get Directions Write a Review

NPPES record last updated: January 20, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Missouri Med Llc NPPES

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

MISSOURI MED LLC (NPI 1477412963), doing business as Missouri Med St Louis, is a healthcare organization registered as a long term care pharmacy in Saint Louis, Missouri and active in the NPI registry since January 2026. The organization lists Jackie Mchugh, Office Manager, as its authorized official.

NPPES Registry Identity

NPI1477412963
Entity TypeOrganization
Primary Taxonomy3336L0003X
Legal Business NameMISSOURI MED LLC
Location Address11643 LILBURN PARK RDSaint Louis, MO 63146-3535
Mailing Address2215 Broadway StCape Girardeau, MO 63701-4403 · (573) 335-3044 · Fax (573) 335-6724
Phone(314) 445-2900
Organization SubpartYes
Authorized OfficialJackie MchughOffice Manager · (573) 335-3044
Enumeration DateJanuary 20, 2026
NPPES CertifiedJanuary 20, 2026
✔ NPI 1477412963 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPharmacy · Long Term Care PharmacySuppliers
Taxonomy Code3336L0003X
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.
11643 LILBURN PARK RD, Saint Louis, MO 63146
Open in Google Maps ↗

Other Names 1

Doing Business AsMissouri Med St Louis

Other Providers at the Same Location NPPES

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

KEITH ALAN WALLACE BS PHARM
Pharmacist
11643 LILBURN PARK RD
SAINT LOUIS, MO 63146
St. Louis County (314) 995-6843

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 Missouri Med LLC's NPI number?

The NPI number for Missouri Med LLC is 1477412963. It was assigned to this organization in the NPPES registry on January 20, 2026. The provider is doing business as Missouri Med St Louis.

Where is Missouri Med LLC located?

Missouri Med LLC is located at 11643 Lilburn Park Rd, Saint Louis, MO 63146. The listed phone number is (314) 445-2900.

What is Missouri Med LLC's specialty?

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

When was this NPI record last updated?

The NPPES record for Missouri Med LLC was last updated on January 20, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 months 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.