Organization
KINKEAD PHARMACY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WENDY S KINKEAD (PRES)
(573) 682-2155
Entity
Organization
Contact information
Practice address
105 S ALLEN ST, CENTRALIA, MO 65240-1303
(573) 682-2155
Mailing address
105 S ALLEN ST, CENTRALIA, MO 65240-1303
(573) 682-2155
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
041845
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
600050702
—
MO
Enumeration date
01/29/2007
Last updated
01/29/2024
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