| NPI | 1558492421 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONALD GENE HOLMAN Pharmacist In Charge 573-346-2300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MO 028456) |
| Enumeration Date | 2007-03-09 |
| Last Update Date | 2023-03-07 |