Organization
KIMBERLING CITY PHARMACY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RUDY JOHNSON R. PH (PHARMACIST OWNER)
(417) 739-2273
Entity
Organization
Contact information
Practice address
41 KIMBERLING CITY CENTER LANE, KIMBERLING CITY, MO 65686-0908
(417) 739-2273
(417) 739-1706
Mailing address
PO BOX 908, 41 KIMBERLING CITY CENTER LANE, KIMBERLING CITY, MO 65686-0908
(417) 739-2273
(417) 739-1706
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
004551
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2622923
NABP
MO
05
—
KI602214603
—
MO
Enumeration date
09/15/2006
Last updated
10/06/2009
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