NPI | 1568551786 |
---|---|
Entity Type | Organization |
Authorized Contact | KOBY PRATER President 417-673-4663 |
Organization Subpart ? | No |
Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: MO 004952) |
Additional Taxonomies | 163WD0400X Registered Nurse, Diabetes Educator |
332B00000X Durable Medical Equipment & Medical Supplies | |
333600000X Pharmacy | |
3336L0003X Pharmacy, Long Term Care Pharmacy | |
Enumeration Date | 2006-10-12 |
Last Update Date | 2020-03-13 |