Organization
KILGORE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANN BROMSTEDT (OWNER)
(573) 447-4444
Entity
Organization
Contact information
Practice address
1608 CHAPEL HILL RD, COLUMBIA, MO 65203-5464
(573) 447-4444
(573) 447-4054
Mailing address
1608 CHAPEL HILL RD, COLUMBIA, MO 65203-5464
(573) 447-4444
(573) 447-4054
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PS006548
MO
3336C0004X
Compounding Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2632570
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
604629204
—
MO
Enumeration date
01/11/2007
Last updated
07/19/2022
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