| NPI | 1861511065 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL HENDRICKS Pharmacist 660-885-6589 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: MO PS004203) |
| Enumeration Date | 2007-03-28 |
| Last Update Date | 2020-08-22 |