| NPI | 1932179579 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEANNE DICKERSON Owner 816-884-4559 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: MO 2002016484) |
| Additional Taxonomies | 333600000X Pharmacy |
| 3336L0003X Pharmacy Long Term Care Pharmacy | |
| Enumeration Date | 2006-01-25 |
| Last Update Date | 2018-07-19 |