| NPI | 1790254647 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIFFANY CHAWNTAY CORYELL Pharmacist 417-861-1800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 183500000X Pharmacist |
| Additional Taxonomies | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
| Enumeration Date | 2018-11-21 |
| Last Update Date | 2018-11-21 |