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Organization
LETASSY PHARMACY
Active
Organization
LETASSY PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BERNARD R LETASSY RPH. (PHARMACIST)
(573) 785-8421
Entity
Organization
Contact information
Practice address
1014 W PINE ST, POPLAR BLUFF, MO 63901-4840
(573) 785-8421
(573) 785-3348
Mailing address
1014 W PINE ST, POPLAR BLUFF, MO 63901-4840
(573) 785-8421
(573) 785-3348
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
026011
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2618568
NAPD
MO
05
—
601504202
—
MO
Enumeration date
05/23/2007
Last updated
08/20/2008
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