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General NPI Number Information
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NPI Number | 1669513594
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Entity Type | Organization
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Legal Business Name | MOBERLY PROFESSIONAL ARTS PHARMACY INC.
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Dates
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Enumeration Date | 02/12/2007
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Last Update Date | 04/15/2008
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Provider Practice Location Address
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Address Line | 1513 UNION AVE
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City | MOBERLY
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State | MO
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Zip | 65270-9407
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Country | US
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Telephone | 660-263-6611
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Fax | 660-263-4819
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Provider Business Mailing Address
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Address Line | 1513 UNION AVE
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City | MOBERLY
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State | MO
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Zip | 65270-9407
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Country | US
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Telephone | 660-263-6611
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Fax | 660-263-4819
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Authorized Official
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Title or Position | PHARMACIST
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Name | BILL BUNTIN
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Credential |
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Telephone | 660-263-6611
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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 | PS003884
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License Number State | MO
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