Organization
M.W.ALLEN PHARMACY INC.
Active
Other names
Village Healthmart Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL W ALLEN RPH (OWNER)
(573) 346-3396
Entity
Organization
Contact information
Practice address
932 N STATE HIGHWAY 5, CAMDENTON, MO 65020-2648
(573) 346-3396
(573) 346-5257
Mailing address
932 N STATE HIGHWAY 5, CAMDENTON, MO 65020-2648
(573) 346-3396
(573) 346-5257
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
004583
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
600659700
—
MO
01
—
620659706
MEDICAID DME
MO
Enumeration date
12/15/2006
Last updated
05/06/2008
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