Organization
KEY COMPOUNDING PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARTIN H MICHEL R.PH., M.B.A., C.D.E (OWNER)
(573) 785-8219
Entity
Organization
Contact information
Practice address
912 NORTH WESTWOOD BLVD, POPLAR BLUFF, MO 63901
(573) 785-8219
(573) 785-8125
Mailing address
912 NORTH WESTWOOD BLVD, POPLAR BLUFF, MO 63901
(573) 785-8219
(573) 785-8125
Taxonomy
Speciality
Code
Description
License number
State
3336C0004X
Compounding Pharmacy
Primary
2004027988
MO
Other
Enumeration date
04/13/2007
Last updated
08/22/2020
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