| NPI | 1508950916 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEITH A SHELTON Owner 573-686-7216 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 333600000X Pharmacy (Licence: MO 004034) | |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2023-03-07 |