| 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 |