# GROVE PHARMACY HOME INFUSION

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1407939416
- **Authorized official:** GARY GROVE (PRES)
- **Authorized official phone:** (417) 881-2910

## Contact information

- **Practice address:** 1522 E SUNSHINE ST, SPRINGFIELD, MO 65804-1214
- **Practice address phone:** (417) 881-2910
- **Mailing address:** 1522 E SUNSHINE ST, SPRINGFIELD, MO 65804-1214

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | 005915 | MO | Yes |

## Other

- **Enumeration date:** 10/23/2006
- **Last updated:** 08/13/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2630564 | OTHER ID NUMBER-COMMERCIAL NUMBER | — |
| 05 | — | 608202503 | — | MO |