Organization
DAN MCHANS STORE INC
Active
Other names
DAN ANS STANS PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAN ROY MCHAN PHD (OWNER)
(417) 326-7666
Entity
Organization
Contact information
Practice address
103 E BROADWAY ST, BOLIVAR, MO 65613-1621
(417) 326-7666
(417) 777-8073
Mailing address
103 E BROADWAY ST, BOLIVAR, MO 65613-1621
(417) 326-7666
(417) 777-8073
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
006087
MO
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2604925
NCPDP
—
05
—
600135305
—
MO
Enumeration date
11/30/2006
Last updated
05/01/2008
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