| NPI | 1174528293 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS E BROCKETT Owner/Pharmacist 573-243-3524 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: MO 10119701) |
| Enumeration Date | 2005-06-15 |
| Last Update Date | 2020-08-22 |