Old Town Pharmacy LLC
Old Town Pharmacy LLC is a healthcare organization registered as Community/Retail Pharmacy in Monett, MO, holding Type 2 (organization) NPI 1578754701 since 2007. The authorized official on file is Shane Becker, Owner/Manager/Pic.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1578754701 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | Old Town Pharmacy LLC |
| Other name | <Unavail> |
| Practice address | 100A CHAPEL DRIVE, Monett, MO, 65708 |
| Phone | 4176351100 |
| Fax | 4176351103 |
| Enumeration date | 2007-08-05 |
| Last updated in NPPES | 2024-06-04 |
Authorized official
| Name | Shane Becker |
|---|---|
| Title | Owner/Manager/Pic |
| Phone | 4176351100 |
Taxonomy & classification
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 3336C0003X | Community/Retail Pharmacy | Secondary | 2007022497 | MO |
| 3336L0003X | Long Term Care Pharmacy | Secondary | — | — |
| 3336C0003X | Community/Retail Pharmacy | Primary | 2014010847 | MO |
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2007022497 | Other | MO | PHARMACY LIC |
| 19735928 | Medicaid | MO | — |
| 2637506 | Other | — | NCPDP |
Copy-ready billing details
Provider: Old Town Pharmacy LLC NPI: 1578754701 Taxonomy: 3336C0003X (Community/Retail Pharmacy) Address: 100A CHAPEL DRIVE, Monett, MO, 65708
Verify this record
Cross-check NPI 1578754701 against the authoritative CMS record: view Old Town 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
How current is this record?
Where is Old Town Pharmacy LLC located?
Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2024-06-04.