Nutritional Support Services
NPI 1679594626ActiveOrganization· Pharmacy, Long Term Care Pharmacy· Fenton, MO
Pharmacy, Long Term Care Pharmacy in Fenton, Missouri, registered in NPPES in July 2006. The authorized official on file is Terry Leeman, President. Enrolled in Medicare as part b supplier - mass immunization (roster biller only).
Overview
| NPI | 1679594626 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jul 22, 2006 |
| Last updated in NPPES | Jan 28, 2020 |
| Certified by provider | Jan 28, 2020 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Pharmacy, Long Term Care Pharmacy Primary | 3336L0003X | 2004034239 | MO |
| Pharmacy, Institutional Pharmacy | 3336I0012X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Mass Immunization (Roster Biller Only) (MO) |
|---|
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