| NPI | 1265421663 |
|---|---|
| Doing Business As | BROADWAY PHARMACY |
| Entity Type | Organization |
| Authorized Contact | KEVIN WOOD Owner 573-335-8207 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: MO 2011012280) |
| Additional Taxonomies | 333600000X Pharmacy |
| 3336M0002X Pharmacy, Mail Order Pharmacy | |
| 3336S0011X Pharmacy, Specialty Pharmacy | |
| Enumeration Date | 2005-10-18 |
| Last Update Date | 2018-07-19 |