| NPI | 1588936371 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE Y. HIEBERT Pharmacy Manager 417-451-7900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251F00000X Home Infusion |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: MO 2012003024) |
| 332BP3500X Durable Medical Equipment & Medical Supplies Parenteral & Enteral Nutrition (Licence: MO 2012003024) | |
| 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: MO 2012003024) | |
| 3336C0004X Pharmacy Compounding Pharmacy | |
| 3336H0001X Pharmacy Home Infusion Therapy Pharmacy (Licence: MO 2012003024) | |
| 3336S0011X Pharmacy Specialty Pharmacy | |
| Enumeration Date | 2012-02-08 |
| Last Update Date | 2025-07-10 |