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1144505447
SI03, INC.
SCOTT CITY, MO
NPI
1144505447
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Entity Type
Organization
Authorized Contact
JEFF FANGER
General Manager
573-388-2301
Organization Subpart ?
No
Primary Taxonomy
335G00000X Medical Foods Supplier
Enumeration Date
2011-10-18
Last Update Date
2011-10-18
Business Address
SI03, INC.
4711 NASH ROAD
SCOTT CITY, MO 63780
Phone number: 573-388-2301
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Mailing Address
SI03, INC.
PO BOX 1715
CAPE GIRARDEAU, MO 63702
Phone number: 573-388-2301
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