| NPI | 1689700379 |
|---|---|
| Doing Business As | MAIN STREET PHARMACY |
| Entity Type | Organization |
| Authorized Contact | TERA JOHNSON Manager 573-649-9229 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: MO 2013000674) |
| Enumeration Date | 2007-02-26 |
| Last Update Date | 2015-02-09 |