Old Town Pharmacy Llc
Community/Retail Pharmacy
100a Chapel Drive, Monett
Missouri, 65708
417-635-1100 417-635-1103
Old Town Pharmacy Llc is a Community/Retail Pharmacy in Monett, Missouri. It is located at 100a Chapel Drive, Monett and it's customer support contact number is 417-635-1100. The authorized person of Old Town Pharmacy Llc is Mr. Shane Michael Becker, PHARMD RPH who is Owner/manager/pic of the pharmacy and his contact number is 417-635-1100. Active license number of Old Town Pharmacy Llc is 2014010847 for Community/Retail Pharmacy in Missouri. Old Town Pharmacy Llc accepts medicare which means medicare covered patients will not be billed for any more than the Medicare deductible and coinsurance.
Old Town Pharmacy Llc is a pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.
Pharmacy Details:
Old Town Pharmacy Llc type, location, contact phone number and fax are as below. Patients can directly walkin to the pharmacy or can call on the below given customer support phone number for enquiries.
| Name: | Old Town Pharmacy Llc |
| Type: | Community/Retail Pharmacy |
| Location: | 100a Chapel Drive, Monett,
Missouri, 65708 |
| Phone: | 417-635-1100 |
| Fax: | 417-635-1103 |
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints of this pharmacy is as below. Person's position and contact details are also mentioned below.
| Name: | Mr. Shane Michael Becker |
| Credentials: | PHARMD RPH |
| Position: | Owner/manager/pic |
| Contact Number: | 417-635-1100 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details of given pharmacy are as mentioned below.
| NPI Number: | 1578754701 |
| NPI Enumeration Date: | 05 Aug, 2007 |
| NPI Last Update On: | 04 Jun, 2024 |
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Old Town Pharmacy Llc are as mentioned below.
| Specialization | License Number | State | Status | |
| Community/Retail Pharmacy | 2014010847 | Missouri | Primary | |
| Community/Retail Pharmacy | 2007022497 | Missouri | Secondary | |
| Long Term Care Pharmacy | | | Secondary | |
Other Medical Identifiers:
Other legacy medical identifiers of the pharmacy such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
| Identifier | Type | State | Issuer |
| 2007022497 | Other | Missouri | Pharmacy Lic |
| 19735928 | Medicaid | Missouri | |
| 2637506 | Other | | Ncpdp |
Medicare Enrollment:
Old Town Pharmacy Llc is enrolled in medicare and it's Pac Id, enrollment Id, registered name and type is as stated below.
| PAC ID: |
Enrollment ID: |
Org Name | Medicare Entity Type |
| 8628262359 | O20101027000284 | Old Town Pharmacy, Llc | PART B SUPPLIER - MASS IMMUNIZATION (ROSTER BILLER ONLY) |
| 8628262359 | O20110418000267 | Old Town Pharmacy, Llc | DME SUPPLIER - PHARMACY |
Products Available:
Old Town Pharmacy Llc has following products available for sale under medicare.
| Products: |
|---|
| • Blood Glucose Monitors & Supplies: Non-mail Order | • Canes & Crutches |
| • Commodes, Urinals, & Bedpans | • Diabetic Shoes & Inserts: Custom Fabricated |
| • Diabetic Shoes & Inserts: Prefabricated | • Enteral Equipment And/or Supplies |
| • Enteral Nutrients | • Heat & Cold Applications |
| • Infusion Pumps & Supplies: Insulin Infusion | • Nebulizer Equipment & Supplies |
| • Orthoses: Off-the-shelf | • Ostomy Supplies |
| • Parenteral Equipment And/or Supplies | • Parenteral Nutrients |
| • Support Surfaces: Pressure Reducing Beds, Mattresses, Overlays, & Pads | • Surgical Dressings |
| • Transcutaneous Electrical Nerve Stimulators (tens) Units | • Urological Supplies |
| • Walkers | • Wheelchairs & Accessories: Standard Manual |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | 100a Chapel Dr,
Monett, Missouri |
| Zip: | 65708 |
| Phone Number: | 417-635-1100 |
| Fax Number: | 417-635-1103 |
Patients can reach Old Town Pharmacy Llc at
100a Chapel Drive, Monett, Missouri or can
call on customer care at 417-635-1100.
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**Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 December, 2025.