| NPI | 1427645613 |
|---|---|
| Doing Business As | MIZZOU PHARMACY - OLD 63 |
| Entity Type | Organization |
| Authorized Contact | FREDERIC A. RANSOM CEO 573-884-0054 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Additional Taxonomies | 333600000X Pharmacy |
| 3336C0004X Pharmacy, Compounding Pharmacy | |
| 3336S0011X Pharmacy, Specialty Pharmacy | |
| Enumeration Date | 2020-12-22 |
| Last Update Date | 2023-06-29 |