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Organization
GROVE PHARMACY HOME INFUSION
Active
Organization
GROVE PHARMACY HOME INFUSION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GARY GROVE (PRES)
(417) 881-2910
Entity
Organization
Contact information
Practice address
1522 E SUNSHINE ST, SPRINGFIELD, MO 65804-1214
(417) 881-2910
Mailing address
1522 E SUNSHINE ST, SPRINGFIELD, MO 65804-1214
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
005915
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2630564
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
608202503
—
MO
Enumeration date
10/23/2006
Last updated
08/13/2014
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