| NPI | 1780789305 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID D. HUBBLE Pharmacist In Charge 660-885-5551 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: MO 2683) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: MO 600129803) |
| Enumeration Date | 2006-09-14 |
| Last Update Date | 2010-07-09 |