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NPI 1124167598

NPI 1124167598 : CURTIS A WOOD R.PH., CGP, FASCAP : LOUISIANA, MO

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General NPI Number Information
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    NPI Number           |    1124167598
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    Entity Type          |    Individual 
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    Provider Name        |    CURTIS A WOOD R.PH., CGP, FASCAP
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    02/05/2007
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    3651 W INDUSTRIAL DR 
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    City                 |    LOUISIANA
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    State                |    MO
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    Zip                  |    63353-3868
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    Country              |    US
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    Telephone            |    800-818-1632
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    17566 DOE RUN RD 
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    City                 |    NEW LONDON
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    State                |    MO
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    Zip                  |    63459-4410
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    Country              |    US
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    Telephone            |    573-985-3403
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    1835G0303X
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    Taxonomy Name        |    Geriatric Pharmacist
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    License Number       |    042931
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    License Number State |    MO
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