Healthcare Provider Details

I. General information

NPI: 1861310047
Provider Name (Legal Business Name): MS MGC INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2026
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

635 S STURGEON ST
MONTGOMERY CITY MO
63361-2707
US

IV. Provider business mailing address

635 S STURGEON ST
MONTGOMERY CITY MO
63361-2707
US

V. Phone/Fax

Practice location:
  • Phone: 573-564-1111
  • Fax: 573-564-2828
Mailing address:
  • Phone: 573-564-1111
  • Fax: 573-564-2828

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: MEGAN MOORE
Title or Position: BOOK KEEPER
Credential:
Phone: 636-579-6750