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Individual

DR. RANDY KYLE MEENTS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PHARM.D.

Contact information

Practice address
105 N. GRAND ST., SUITE 1, GREENFIELD, MO 65661-0158
(417) 637-2909
(417) 637-5621
Mailing address
105 N. GRAND ST., SUITE 1, P.O. BOX 158, GREENFIELD, MO 65661-0158
(417) 637-2909
(417) 637-5621

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
040294
MO
1835G0303X
Geriatric Pharmacist
Primary
040294
MO
1835P1200X
Pharmacotherapy Pharmacist
040294
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
358397800
MO
Enumeration date
12/08/2005
Last updated
12/17/2018
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