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General NPI Number Information
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NPI Number | 1518095181
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Entity Type | Organization
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Legal Business Name | NOEL PHARMACY LLC
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Dates
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Enumeration Date | 03/02/2007
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Last Update Date | 05/02/2008
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Provider Practice Location Address
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Address Line | 222 MAIN
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City | NOEL
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State | MO
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Zip | 64854-0428
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Country | US
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Telephone | 417-475-3292
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Fax | 417-475-3287
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Provider Business Mailing Address
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Address Line | PO BOX 1034
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City | NOEL
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State | MO
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Zip | 64854-0428
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Country | US
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Telephone | 417-475-3292
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Fax | 417-475-3287
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Authorized Official
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Title or Position | PHARMACIST
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Name | GARY MASSEY
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Credential |
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Telephone | 417-475-3292
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 3655
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License Number State | MO
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