| NPI | 1780603969 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID T LETASSY Rph 573-785-0048 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy, Long Term Care Pharmacy (Licence: MO 004918) |
| Additional Taxonomies | 332BN1400X Durable Medical Equipment & Medical Supplies, Nursing Facility Supplies (Licence: MO 622577708) |
| 251K00000X Public Health or Welfare (Licence: MO 854887502) | |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2009-10-08 |