| NPI | 1528375508 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RON FITZWATER Manager 573-636-7522 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 333600000X Pharmacy | |
| Enumeration Date | 2010-09-11 |
| Last Update Date | 2010-09-11 |