| NPI | 1295366797 |
|---|---|
| Doing Business As | MAIN STREET PHARMACY |
| Entity Type | Organization |
| Authorized Contact | KEVIN WOOD Member/Manager 573-335-8207 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2020-02-03 |
| Last Update Date | 2020-06-16 |