Organization
GIDEON PHARMACY LLC
Active
Other names
John's Pharmacy Gideon
Organization subpart
No
Provider details
NPI number
Authorized official
ABRAHAM T FUNK (OWNER)
(573) 334-1300
Entity
Organization
Contact information
Practice address
111 MAIN STREET, GIDEON, MO 63848
(573) 448-3333
(573) 448-3335
Mailing address
2001 INDEPENDENCE ST, CAPE GIRARDEAU, MO 63703-5805
(573) 448-3333
(573) 448-3335
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1053702118
—
MO
Enumeration date
02/11/2015
Last updated
05/17/2024
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