| NPI | 1730174616 |
|---|---|
| Doing Business As | COUNTRYSIDE PHARMACY |
| Entity Type | Organization |
| Authorized Contact | ANNE MARIE BARR Managing Member 816-324-5111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: MO 2001024920) |
| Additional Taxonomies | 3336L0003X Pharmacy, Long Term Care Pharmacy |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2005-09-15 |
| Last Update Date | 2016-01-25 |