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Organization

CURATORS OF THE UNIVERSITY OF MISSOURI

Active
Other names
MIZZOU PHARMACY - KEENE STREET
Organization subpart
No

Provider details

NPI number
Authorized official
FREDERIC A. RANSOM (CEO)
(573) 884-0054
Entity
Organization

Contact information

Practice address
404 N KEENE ST, COLUMBIA, MO 65201-6626
(573) 499-6022
(573) 875-9805
Mailing address
PO BOX 843310, KANSAS CITY, MO 64184-3310
(573) 499-6022

Taxonomy

Speciality
Code
Description
License number
State
333600000X
Pharmacy
3336C0003X
Community/Retail Pharmacy
Primary
1999136031
MO
3336C0004X
Compounding Pharmacy

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2051278
PK
05
600420301
MO
Enumeration date
08/18/2006
Last updated
06/29/2023
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