Organization
GPMO, INC
Active
Other names
Grand Pharmacy Ralls County
Organization subpart
No
Provider details
NPI number
Authorized official
GREGORY GILMORE (OWNER)
(573) 822-1896
Entity
Organization
Contact information
Practice address
400 BROADWAY ST., CENTER, MO 63436
(572) 221-2792
Mailing address
733 GRAND AVE, HANNIBAL, MO 63401-3183
(573) 221-2792
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
602201303
—
MO
Enumeration date
02/04/2021
Last updated
02/04/2021
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