| NPI | 1235242876 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON DODGE Owner/Pharmacist 660-327-4514 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: MO 2010000018) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 332BX2000X Durable Medical Equipment & Medical Supplies Oxygen Equipment & Supplies | |
| 333600000X Pharmacy | |
| 3336C0004X Pharmacy Compounding Pharmacy | |
| 3336L0003X Pharmacy Long Term Care Pharmacy | |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2025-04-21 |