Organization
TIM MITCHELL MEDICAL, INC
Active
Other names
Mitchell's Downtown Drug Store
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TIM MITCHELL R.PH. (OWNER/PRESIDENT)
(417) 451-3776
Entity
Organization
Contact information
Practice address
115 E HICKORY ST, NEOSHO, MO 64850-1806
(417) 451-3776
(417) 451-2332
Mailing address
719 S NEOSHO BLVD, NEOSHO, MO 64850-2051
(417) 455-1883
(417) 455-2781
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
600003470
—
MO
Enumeration date
09/13/2013
Last updated
03/24/2022
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