Organization
ADVOCATES FOR A HEALTHY COMMUNITY
Active
Other names
Jordan Valley Community Health Center Pharmacy #2
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MATTHEW STINSON MD (CEO)
(417) 831-0150
Entity
Organization
Contact information
Practice address
440 E TAMPA ST, SPRINGFIELD, MO 65806-1131
(417) 831-0150
Mailing address
440 E TAMPA ST, SPRINGFIELD, MO 65806-1131
(417) 831-0150
Taxonomy
Speciality
Code
Description
License number
State
3336C0002X
Clinic Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
2009017150
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2638647
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
06/30/2009
Last updated
07/30/2024
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