Organization
JUSTBREN INC
Active
Other names
Parkway Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
BRENDAN WEBBER (DIRECTOR OF OPERATIONS)
(573) 581-7561
Entity
Organization
Contact information
Practice address
340 KELLEY PKWY, MEXICO, MO 65265-3811
(573) 567-7077
(573) 567-7079
Mailing address
340 KELLEY PKWY STE D, MEXICO, MO 65265-3811
(573) 567-7077
(573) 567-7079
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
2016024778
MO
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1285181081
—
MO
01
—
2164071
PK
—
Enumeration date
09/09/2016
Last updated
02/21/2017
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