NPI: 1336251339 · FAYETTE, MO 65248 · Compounding Pharmacy · NPI assigned 08/31/2006
| Authorized Official | TADRUS, CHRISTIAN (OWNER) |
| NPI Enumeration Date | 08/31/2006 |
Other providers sharing the same authorized official: TADRUS, CHRISTIAN
| Provider | City | State | Total Paid |
|---|---|---|---|
| SAMS PRESCRIPTION SHOP INC | MOBERLY | MO | $207K |
| SAMS PRESCRIPTION SHOP INC | MOBERLY | MO | $319.52 |
| Year | Claims | Total Paid |
|---|---|---|
| 2019 | 179 | $14K |
| 2020 | 257 | $26K |
| 2021 | 87 | $11K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| T2029 | Specialized medical equipment, not otherwise specified, waiver | 523 | 470 | $51K |