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General NPI Number Information
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NPI Number | 1386112829
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Entity Type | Organization
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Legal Business Name | MEDLEY PHARMACY
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Dates
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Enumeration Date | 11/02/2018
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Last Update Date | 09/12/2022
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Provider Practice Location Address
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Address Line | 1100B S BISHOP AVE
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City | ROLLA
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State | MO
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Zip | 65401-4418
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Country | US
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Telephone | 573-308-4899
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 528 330 N FRANKLIN
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City | CUBA
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State | MO
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Zip | 65453-0528
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | LOCAL HEALTH MISSOURI INC
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Credential | PHARM D
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Telephone | 573-885-0885
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number |
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License Number State |
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