| NPI | 1265649388 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAYBELLE M BOWENS Pharmacy Director 816-889-4652 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0002X Pharmacy, Clinic Pharmacy (Licence: MO 28254) |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2018-06-07 |