| NPI | 1700863180 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN MADDOX Chief Financial Officer 314-481-1615 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: MO 2003004144) |
| Enumeration Date | 2005-12-28 |
| Last Update Date | 2023-03-07 |