| NPI | 1124123724 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMUEL W. KERNOHAN Pharmacist In Charge 660-885-2227 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: MO 4203) |
| Enumeration Date | 2006-09-14 |
| Last Update Date | 2007-11-19 |