Organization
CITIZENS MEMORIAL HOSPITAL DISTRICT
Active
Other names
Citizens Memorial Outpatient Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
DONALD BABB (CEO)
(417) 326-6501
Entity
Organization
Contact information
Practice address
1301-B NORTH OAKLAND, BOLIVAR, MO 65613
(417) 326-6003
(417) 777-5806
Mailing address
1500 N OAKLAND AVE, BOLIVAR, MO 65613-3011
(417) 326-6003
(417) 777-5806
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
2002031104
MO
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2150441
PK
—
Enumeration date
09/09/2014
Last updated
11/09/2015
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