| NPI | 1326132739 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOMINICK J BERTONCINO Owner Pharmacist 417-673-4909 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy |
| Additional Taxonomies | 333600000X Pharmacy (Licence: MO 006106) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2008-06-18 |