| NPI | 1366504805 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS G SQUIRES Manager 816-231-2330 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: MO 2002001504) |
| Enumeration Date | 2006-12-14 |
| Last Update Date | 2020-08-22 |