# WRINKLE'S PHARMACY, INC.

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

## Provider details

- **NPI number:** 1912988270
- **Authorized official:** TOM GLENSKI (SECRETARY)
- **Authorized official phone:** (816) 238-4522

## Contact information

- **Practice address:** 5409 LAKE AVE, SAINT JOSEPH, MO 64504-1439
- **Practice address phone:** (816) 238-4522
- **Mailing address:** 6210 NW COGDILL RD, KING CITY, MO 64463-9247

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | 002729 | MO | Yes |

## Other

- **Enumeration date:** 11/12/2005
- **Last updated:** 11/05/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2603074 | NABP/NACDS | — |