Organization
MS MGC INC
Active
Other names
MEDICINE SHOPPE
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JASON ALEXANDER WANG PHARMD (VICE PRESIDENT)
(573) 564-1111
Entity
Organization
Contact information
Practice address
635 S STURGEON ST, MONTGOMERY CITY, MO 63361-2707
(573) 564-1111
(573) 564-2828
Mailing address
635 S STURGEON ST, MONTGOMERY CITY, MO 63361-2707
(573) 564-1111
(573) 564-2828
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2633041
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
604842302
—
MO
Enumeration date
08/31/2006
Last updated
06/10/2024
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