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General NPI Number Information
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NPI Number | 1932863867
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Entity Type | Organization
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Legal Business Name | SWEET SPRINGS PHARMACY INC
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Dates
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Enumeration Date | 10/27/2021
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Last Update Date | 04/05/2022
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Provider Practice Location Address
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Address Line | 807 E BROADWAY ST STE B
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City | BRUNSWICK
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State | MO
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Zip | 65236-1468
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Country | US
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Telephone | 660-548-2118
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Fax | 660-548-2119
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Provider Business Mailing Address
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Address Line | PO BOX 737
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City | CHILLICOTHEE
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State | MO
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Zip | 64601-0737
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Country | US
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Telephone | 660-247-1580
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Fax | 660-707-0829
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Authorized Official
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Title or Position | COO
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Name | ANTHONY EUGENE CLARK
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Credential |
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Telephone | 660-247-1580
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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 |
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License Number State |
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