Organization
THAYER DRUG STORE LLC
Active
Other names
THAYER DRUG STORE
Organization subpart
No
Provider details
NPI number
Authorized official
GINNY ALFORD RPH (OWNER PHARMACIST)
(417) 264-3784
Entity
Organization
Contact information
Practice address
623 S 6TH ST, THAYER, MO 65791-1436
(417) 264-3784
(417) 264-3794
Mailing address
623 S 6TH ST, THAYER, MO 65791-1436
(417) 264-3784
(417) 264-3794
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
2006034249
MO
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2049527
PK
—
Enumeration date
11/15/2006
Last updated
10/11/2016
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