Organization
EASTERS PHARMACY
Active
Other names
EASTERS PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID JENNINGS (PIC/MANAGER)
(660) 359-2216
Entity
Organization
Contact information
Practice address
1705 E 9TH ST, TRENTON, MO 64683-2641
(660) 359-2216
(660) 359-4593
Mailing address
1705 E 9TH ST, TRENTON, MO 64683-2641
(660) 359-2216
(660) 359-4593
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
030019
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2615271
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
600057905
—
MO
Enumeration date
03/23/2007
Last updated
01/28/2010
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