| NPI | 1043309263 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANA KOLL Pharmaist 660-438-5162 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: MO 2004006506) |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2017-04-18 |