Organization
TIM MITCHELL MEDICAL, INC
Active
Other names
Mitchell's Uptown Drug Store
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL C SMITH R.PH. (MANAGER)
(417) 451-9301
Entity
Organization
Contact information
Practice address
1504 N BUSINESS 49 HWY, NEOSHO, MO 64850
(417) 451-9301
(417) 451-9307
Mailing address
1504 N BUSINESS 49 HWY, NEOSHO, MO 64850
(417) 455-1883
(417) 455-2781
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
2004010987
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
606120509
—
MO
05
—
626120505
—
MO
Enumeration date
09/11/2006
Last updated
12/29/2021
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