Organization
PRATT'S REXALL DRUGS, INC
Active
Other names
Pratt's Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CRAIG NEAL WILLIMANN R. PH. (PRESIDENT)
(573) 237-3321
Entity
Organization
Contact information
Practice address
100 DWAYNE VON BEHREN DR, NEW HAVEN, MO 63068-3207
(573) 237-3321
(573) 237-2005
Mailing address
100 DWAYNE VON BEHREN DR, NEW HAVEN, MO 63068-3207
(573) 237-3321
(573) 237-2005
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
000129
MO
314000000X
Skilled Nursing Facility
000129
MO
3336C0003X
Community/Retail Pharmacy
Primary
129
MO
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
600447007
—
MO
05
—
620447003
—
MO
Enumeration date
09/22/2006
Last updated
12/27/2022
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