| NPI | 1164284634 |
|---|---|
| Doing Business As | MAIN STREET PHARMACY LTC |
| Entity Type | Organization |
| Authorized Contact | BRYAN HUBBARD Owner 573-649-9229 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy, Long Term Care Pharmacy |
| Enumeration Date | 2024-01-29 |
| Last Update Date | 2024-01-29 |