| NPI | 1265945216 |
|---|---|
| Doing Business As | STADIUM PHARMACY |
| Entity Type | Organization |
| Authorized Contact | VIKRANTH K ANNEBOINA Owner 636-544-4525 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: MO 2017040100) |
| Enumeration Date | 2017-11-13 |
| Last Update Date | 2018-06-16 |