| NPI | 1154427516 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY D. KLINE-RADFORD Pharmacist In Charge 660-885-4646 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0002X Pharmacy, Clinic Pharmacy (Licence: MO 5423) |
| Enumeration Date | 2006-09-15 |
| Last Update Date | 2020-08-22 |