| NPI | 1669867396 |
|---|---|
| Doing Business As | INTEGRIS PHARMACY 4173 |
| Entity Type | Organization |
| Authorized Contact | DONNA M WALLACE Assistant Treasurer 636-359-4890 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: OK 5-7196) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2015-03-31 |
| Last Update Date | 2024-08-21 |