| NPI | 1336137108 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHTON T. STUTE Pharmacist 816-415-9995 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: KS 2202348) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: MO 2003007191) |
| Enumeration Date | 2005-10-06 |
| Last Update Date | 2014-01-09 |