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1085 Maple St Farmington MO 63640-1955 | |
| (573) 756-5353 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Pharmacy |
| Location | 1085 Maple St, Farmington, Missouri |
| Authorized Official Name and Position | Angela Martin-davis (PRESIDENT) |
| Authorized Official Contact | 3142063712 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1085 Maple St Farmington MO 63640-1955 Ph: (573) 756-5353 | 1085 Maple St Farmington MO 63640-1955 Ph: (573) 756-5353 |
| NPI Number | 1114268935 |
|---|---|
| Provider Enumeration Date | 03/04/2013 |
| Last Update Date | 08/18/2023 |
| Certification Date | 08/18/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114268935 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
| 333600000X | Pharmacy | (* (Not Available)) | Primary |
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