| NPI | 1659313443 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIZABETH ANN BERTONCINO Owner 417-673-8090 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: MO 2002029306) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2006-06-13 |
| Last Update Date | 2020-08-22 |