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Organization
RKJ HOLDINGS LLC
Active
Organization
RKJ HOLDINGS LLC
Active
Other names
Liberty Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
RONALD JENSEN (SOLE OWNER)
(417) 255-6713
Entity
Organization
Contact information
Practice address
508-2 W. US 60, MOUNTAIN VIEW, MO 65548
(417) 256-7706
Mailing address
10370 PR 8827, WEST PLAINS, MO 65775
(417) 255-6713
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
2015038140
MO
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2154508
PK
—
Enumeration date
10/27/2015
Last updated
10/27/2015
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