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General NPI Number Information
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NPI Number | 1336995109
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Entity Type | Organization
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Legal Business Name | MIKE STUART ENTERPRISES, INC.
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Dates
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Enumeration Date | 04/24/2024
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Last Update Date | 04/24/2024
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Provider Practice Location Address
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Address Line | 16269 US HIGHWAY 160
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City | FORSYTH
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State | MO
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Zip | 65653-7122
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Country | US
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Telephone | 417-546-5151
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Fax | 417-546-4591
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Provider Business Mailing Address
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Address Line | 18565 BUSINESS 13
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City | BRANSON WEST
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State | MO
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Zip | 65737-9659
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Country | US
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Telephone | 417-272-0471
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF FINANCE
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Name | KAREN A KNEBEL
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Credential |
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Telephone | 417-272-0471
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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