Healthcare Provider Details

I. General information

NPI: 1093871360
Provider Name (Legal Business Name): ASSET RX INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/29/2006
Last Update Date: 03/30/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

408 N 4TH ST STE A
ODESSA MO
64076-1152
US

IV. Provider business mailing address

408 N 4TH ST STE A
ODESSA MO
64076-1152
US

V. Phone/Fax

Practice location:
  • Phone: 816-633-8000
  • Fax: 816-633-8600
Mailing address:
  • Phone: 816-633-8000
  • Fax: 816-633-8600

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number2007003456
License Number StateMO

VIII. Authorized Official

Name: CHRISTINE GIBSON
Title or Position: PHARMACIST AND OWNER
Credential:
Phone: 816-633-8000