Dan Mchan Store in

NPI #1063557874 in Bolivar, Missouri

Provider Information

NPI Number: 1063557874
Entity Type: Organization
Organization Name: Dan Mchan Store in
Primary Specialty: Pharmacist
Enumeration Date: Feb 20, 2007
Last Updated: May 6, 2008

Practice Location

Address: 103 E BROADWAY
City: Bolivar
State: Missouri
ZIP Code: 65613-1621
Phone: (417) 326-7666

Authorized Official

Name: MR. DANNY ROY MCHAN
Title: INCORPORATOR
Phone: (417) 326-7666

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pharmacist	183500000X	Primary

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