Organization
MARTIN PHARMACY SERVICES, LLC
Active
Other names
Wilkinson Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREW MARTIN RPH (OWNER/PIC)
(417) 358-4840
Entity
Organization
Contact information
Practice address
2017 S GARRISON AVE, CARTHAGE, MO 64836-3613
(417) 358-4840
(417) 358-8591
Mailing address
2017 S GARRISON AVE, CARTHAGE, MO 64836-3613
(417) 358-4840
(417) 358-8591
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2021015449
STATE BOARD OF PHARMACY
MO
01
—
2051462
PK
—
05
—
600308803
—
MO
Enumeration date
10/03/2006
Last updated
05/07/2021
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