| NPI | 1013062090 |
|---|---|
| Doing Business As | STADIUM PHARMACY |
| Entity Type | Organization |
| Authorized Contact | VIKRANTH ANNEBOINA Member 816-356-4600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: MO 2016039188) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2017-04-28 |