| NPI | 1134233109 |
|---|---|
| Doing Business As | LAKE REGIONAL PHARMACY - OBMP |
| Entity Type | Organization |
| Authorized Contact | KEVIN MCROBERTS CEO 573-348-8756 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: MO 2001028176) |
| Additional Taxonomies | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| 3336L0003X Pharmacy, Long Term Care Pharmacy | |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2023-10-16 |