Organization
INFINITY ENDEAVORS
Active
Other names
Laker Drug
Organization subpart
No
Provider details
NPI number
Authorized official
GREG BOREN (OWNER)
(573) 434-2783
Entity
Organization
Contact information
Practice address
72 S BUSINESS ROUTE 5, CAMDENTON, MO 65020-8892
(573) 873-2626
(573) 873-2633
Mailing address
34 LAKESHIRE DR, CAMDENTON, MO 65020-3807
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
2012000476
MO
3336C0004X
Compounding Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2133019
PK
—
05
—
609531504
—
MO
Enumeration date
11/23/2011
Last updated
02/20/2017
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