| NPI | 1457758153 |
|---|---|
| Doing Business As | BROADWAY PHARMACY LTC |
| Entity Type | Organization |
| Authorized Contact | KEVIN WOOD Director Of Pharmacy 573-576-3029 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy, Long Term Care Pharmacy (Licence: MO PS2014040344) |
| Enumeration Date | 2014-11-24 |
| Last Update Date | 2018-07-24 |