| NPI | 1336343227 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CONNIE JEAN BLACKFORD Member, Manager 816-918-6467 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: MO 2007016458) |
| Enumeration Date | 2007-06-13 |
| Last Update Date | 2008-06-23 |