Healthcare Provider Details
I. General information
NPI: 1922032903
Provider Name (Legal Business Name): CURATORS OF THE UNIVERSITY OF MISSOURI
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/10/2006
Last Update Date: 04/08/2025
Certification Date: 04/08/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
901 KIDWELL DR
VERSAILLES MO
65084
US
IV. Provider business mailing address
901 KIDWELL DR
VERSAILLES MO
65084
US
V. Phone/Fax
- Phone: 573-378-4661
- Fax: 573-378-5053
- Phone: 573-378-4661
- Fax: 573-378-5053
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336C0004X |
| Taxonomy | Compounding Pharmacy |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336L0003X |
| Taxonomy | Long Term Care Pharmacy |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | 003197 |
| License Number State | MO |
VIII. Authorized Official
Name: MR.
FREDERIC
A.
RANSOM
Title or Position: CEO
Credential:
Phone: 573-884-0054