| NPI | 1487857090 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEVON NORTHON GOLDING Owner 314-772-1444 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 3336C0002X Pharmacy Clinic Pharmacy |
| Additional Taxonomies | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: MO 2007033165) |
| Enumeration Date | 2007-06-10 |
| Last Update Date | 2007-10-22 |