| NPI | 1861483232 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD FOOK Phcy Director 314-205-6291 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: MO 2008006745) |
| Additional Taxonomies | 3336L0003X Pharmacy Long Term Care Pharmacy |
| Enumeration Date | 2005-11-03 |
| Last Update Date | 2015-10-12 |