Kilgore Inc
Kilgore Inc is a healthcare organization registered as Community/Retail Pharmacy in Columbia, MO, holding Type 2 (organization) NPI 1417901646 since 2006. The authorized official on file is Ann Bromstedt, Owner.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1417901646 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | Kilgore Inc |
| Other name | <Unavail> |
| Practice address | 700 N PROVIDENCE RD, Columbia, MO, 65203 |
| Phone | 5734420194 |
| Fax | 5734438253 |
| Enumeration date | 2006-05-20 |
| Last updated in NPPES | 2016-01-21 |
Authorized official
| Name | Ann Bromstedt |
|---|---|
| Title | Owner |
| Phone | 5734420194 |
Taxonomy & classification
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 3336C0004X | Compounding Pharmacy | Secondary | — | — |
| 3336L0003X | Long Term Care Pharmacy | Secondary | — | — |
| 332B00000X | Durable Medical Equipment & Medical Supplies | Secondary | — | — |
| 3336C0003X | Community/Retail Pharmacy | Primary | 2008000930 | MO |
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 850587205 | Medicaid | MO | — |
| 2047047 | Other | — | PK |
| 600587208 | Medicaid | MO | — |
| 620587204 | Medicaid | MO | — |
| 600587205 | Medicaid | MO | — |
Copy-ready billing details
Provider: Kilgore Inc NPI: 1417901646 Taxonomy: 3336C0003X (Community/Retail Pharmacy) Address: 700 N PROVIDENCE RD, Columbia, MO, 65203
Providers at this address
| NPI | Name | Type | Specialty | Location |
|---|---|---|---|---|
| 1962798702 | Catherine Rudder | Individual | Pharmacist | Columbia, MO |
| 1275897753 | Heather Ninichuck | Individual | Pharmacist | Columbia, MO |
| 1679837165 | Laura Kingsley | Individual | Pharmacist | Columbia, MO |
| 1821352311 | Jameson Blackford | Individual | Pharmacist | Columbia, MO |
| 1336404144 | Michael Mazzola | Individual | Pharmacist | Columbia, MO |
| 1336523745 | Kilgore Inc | Organization | Long Term Care Pharmacy | Columbia, MO |
| 1932725033 | Kilgore Inc | Organization | Long Term Care Pharmacy | Columbia, MO |
| 1033786652 | Jane Maclellan | Individual | Pharmacist | Columbia, MO |
Verify this record
Cross-check NPI 1417901646 against the authoritative CMS record: view Kilgore Inc 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 is a Type 2 NPI?
What type of organization is Kilgore Inc?
Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2016-01-21.