Organization
BSAP LLC
Active
Other names
ADVANCE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
BRUCE DOVIN RPH (PIC)
(573) 722-3562
Entity
Organization
Contact information
Practice address
110 S OAK ST, ADVANCE, MO 63730-8343
(573) 722-3562
(573) 722-3569
Mailing address
110 S OAK ST, ADVANCE, MO 63730-8343
(573) 722-3562
(573) 722-3569
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
2009002322
MO
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2050340
PK
—
Enumeration date
06/10/2006
Last updated
04/11/2016
About Stedi
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