Organization
OLD TOWN MEDICAL EQUIPMENT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SHANE MICHAEL BECKER PHARM D RPH (OWNER/PHARMACIST/PIC)
(417) 635-1100
Entity
Organization
Contact information
Practice address
100 CHAPEL DR STE E, MONETT, MO 65708-9378
(417) 635-1100
(800) 805-6180
Mailing address
100 CHAPEL DR STE E, MONETT, MO 65708-9378
(417) 635-1100
(800) 805-6180
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
06/21/2016
Last updated
06/21/2016
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