| NPI | 1578754701 |
|---|---|
| Doing Business As | OLD TOWN PHARMACY |
| Entity Type | Organization |
| Authorized Contact | SHANE MICHAEL BECKER Owner/Manager/PIC 417-635-1100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: MO 2014010847) |
| Additional Taxonomies | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: MO 2007022497) |
| 3336L0003X Pharmacy, Long Term Care Pharmacy | |
| Enumeration Date | 2007-08-05 |
| Last Update Date | 2024-06-04 |