NPI | 1902654791 |
---|---|
Entity Type | Organization |
Authorized Contact | KENNETH BROOKS MILLER CEO 417-831-0150 |
Organization Subpart ? | No |
Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
Additional Taxonomies | 3336C0003X Pharmacy Community/Retail Pharmacy |
Enumeration Date | 2024-05-08 |
Last Update Date | 2024-05-08 |