| NPI | 1285645820 |
|---|---|
| Doing Business As | MOUNTAIN GROVE PHARMACY |
| Entity Type | Organization |
| Authorized Contact | CHRISTINE COFFMAN PIC 417-926-9655 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: MO 2015006569) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2006-08-10 |
| Last Update Date | 2024-11-26 |