Provider Demographics
NPI:1700627635
Name:JOHNSTON DRUG - SHELBINA
Entity type:Organization
Organization Name:JOHNSTON DRUG - SHELBINA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LYNN
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:PERRIGO
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:573-515-4060
Mailing Address - Street 1:107 E WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:SHELBINA
Mailing Address - State:MO
Mailing Address - Zip Code:63468-1321
Mailing Address - Country:US
Mailing Address - Phone:660-346-7040
Mailing Address - Fax:
Practice Address - Street 1:107 E WALNUT ST
Practice Address - Street 2:
Practice Address - City:SHELBINA
Practice Address - State:MO
Practice Address - Zip Code:63468-1321
Practice Address - Country:US
Practice Address - Phone:660-346-7040
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-04
Last Update Date:2024-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy