| NPI | 1164164976 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ABRAHAM FUNK Owner 573-334-1300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Additional Taxonomies | 3336C0004X Pharmacy, Compounding Pharmacy |
| Enumeration Date | 2022-04-12 |
| Last Update Date | 2022-04-22 |