| NPI | 1639253990 |
|---|---|
| Other Name | MERCYONE WESTSIDE PHARMACY |
| Entity Type | Organization |
| Authorized Contact | MARK TRAMMEL Asst Treasurer 641-428-7984 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: IA 74) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2024-10-10 |