| NPI | 1104802560 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT E. DAVIDSON Registered Pharmacist 417-624-6800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: MO 004350) |
| Enumeration Date | 2005-12-19 |
| Last Update Date | 2020-08-22 |