Organization
DAN MCHAN STORE IN
Active
Other names
Dan & Stans Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DANNY ROY MCHAN (INCORPORATOR)
(417) 326-7666
Entity
Organization
Contact information
Practice address
103 E BROADWAY, BOLIVAR, MO 65613-1621
(417) 326-7666
(417) 777-8073
Mailing address
103 E BROADWAY, BOLIVAR, MO 65613-1621
(417) 326-7666
(417) 777-8073
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
006087
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
006087
LICENSE
MO
Enumeration date
02/20/2007
Last updated
05/06/2008
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