Healthcare Provider Details

I. General information

NPI: 1619803749
Provider Name (Legal Business Name): KILGORE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2026
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1608 CHAPEL HILL RD STE E
COLUMBIA MO
65203-5464
US

IV. Provider business mailing address

1608 CHAPEL HILL RD STE E
COLUMBIA MO
65203-5464
US

V. Phone/Fax

Practice location:
  • Phone: 573-447-4444
  • Fax:
Mailing address:
  • Phone: 573-447-4444
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: WILLIAM ARNOLD MORRISSEY
Title or Position: PRESIDENT
Credential:
Phone: 573-442-0914