State of Missouri
NPI #1669511093 in Farmington, Missouri
Provider Information
- NPI Number
- 1669511093
- Entity Type
- Organization
- Organization Name
- State of Missouri
- Primary Specialty
- Pharmacy - Institutional Pharmacy
- Enumeration Date
- Feb 5, 2007
- Last Updated
- Aug 28, 2020
Practice Location
- Address
- 1010 W COLUMBIA ST
- City
- Farmington
- State
- Missouri
- ZIP Code
- 63640-2902
- Phone
- (573) 218-6759
Authorized Official
- Name
- MOLLY JANE BOECKMANN
- Title
- DIRECTOR OF ADMINISTRATIVE SERVICES
- Phone
- (573) 751-4055
Specialties & Taxonomy Codes
| Specialty |
|---|
| Pharmacy |
| Pharmacy - Institutional Pharmacy — Institutional Pharmacy |
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