| NPI | 1902974140 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK KLEINBECK President 573-686-6211 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: MO 2004019998) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2006-12-04 |
| Last Update Date | 2011-11-16 |