Organization
MUSTANG DRUG INC
Active
Other names
MUSTANG DRUG
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL THORTON (PRESIDENT)
(417) 845-7799
Entity
Organization
Contact information
Practice address
704 C SOUTH HWY 59, ANDERSON, MO 64831
(417) 845-7799
(417) 845-7797
Mailing address
PO BOX 418, ANDERSON, MO 64831-0418
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
1999140201
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2048293
PK
—
05
—
604754101
—
MO
Enumeration date
08/18/2006
Last updated
06/28/2016
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