| NPI | 1144701079 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYAN KENT SUMMERS President 660-885-3034 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Additional Taxonomies | 333600000X Pharmacy (Licence: MO 2018030729) |
| 3336C0004X Pharmacy, Compounding Pharmacy | |
| Enumeration Date | 2018-08-28 |
| Last Update Date | 2022-01-11 |