Organization
ST. JOHN'S CLINIC INC
Active
Other names
St. John's Pharmacy-Rolla
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROB D SHOCKLEY RPH (RETAIL PHARMACY COORDINATOR)
(417) 820-6624
Entity
Organization
Contact information
Practice address
1100 WEST 10TH STREET, SUITE 150, ROLLA, MO 65401
(573) 426-4931
(573) 426-4932
Mailing address
1100 WEST 10TH STREET, SUITE 150, ROLLA, MO 65401
(573) 426-4931
(573) 426-4932
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
2006027507
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
MO
Enumeration date
10/11/2006
Last updated
08/22/2020
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