Poplar Bluff Pharmacy LLC
Poplar Bluff Pharmacy LLC is a healthcare organization registered as Community/Retail Pharmacy in Poplar Bluff, MO, holding Type 2 (organization) NPI 1275084865 since 2016. The authorized official on file is Abraham Funk, Owner.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1275084865 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | Poplar Bluff Pharmacy LLC |
| Other name | <Unavail> |
| Practice address | 909 W PINE ST, Poplar Bluff, MO, 63901 |
| Phone | 5737850984 |
| Fax | 5737852257 |
| Enumeration date | 2016-10-18 |
| Last updated in NPPES | 2025-09-19 |
Authorized official
| Name | Abraham Funk |
|---|---|
| Title | Owner |
| Phone | 5737850984 |
Taxonomy & classification
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 333600000X | Pharmacy | Secondary | — | — |
| 3336C0004X | Compounding Pharmacy | Secondary | — | — |
| 3336L0003X | Long Term Care Pharmacy | Secondary | — | — |
| 3336C0003X | Community/Retail Pharmacy | Primary | 2016042382 | MO |
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 600059703 | Medicaid | MO | — |
| 2166615 | Other | — | PK |
Copy-ready billing details
Provider: Poplar Bluff Pharmacy LLC NPI: 1275084865 Taxonomy: 3336C0003X (Community/Retail Pharmacy) Address: 909 W PINE ST, Poplar Bluff, MO, 63901
Providers at this address
| NPI | Name | Type | Specialty | Location |
|---|---|---|---|---|
| 1104961515 | Gary Simmons | Individual | Pharmacist | Poplar Bluff, MO |
| 1629103643 | E & D Drugs,Inc. | Organization | Pharmacist | Poplar Bluff, MO |
| 1003102153 | The Other Side Home Health Equipment and Supply | Organization | Pharmacy | Poplar Bluff, MO |
| 1700207073 | Whitney Chronister | Individual | Pharmacist | Poplar Bluff, MO |
| 1750138368 | Aaron Vincent | Individual | Pharmacist | Poplar Bluff, MO |
| 1093556011 | Aftan Swindle | Individual | Pharmacist | Poplar Bluff, MO |
Verify this record
Cross-check NPI 1275084865 against the authoritative CMS record: view Poplar Bluff Pharmacy LLC on the official NPPES registry .
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.
Frequently asked questions
What type of organization is Poplar Bluff Pharmacy LLC?
What is a Type 2 NPI?
Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2025-09-19.