| NPI | 1114377074 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANE MICHAEL BECKER Owner/Pharmacist/PIC 417-635-1100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2016-06-21 |
| Last Update Date | 2016-06-21 |