Organization
MARSHFIELD CLINIC PHARMACY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL ANTHONY VINEHOUT R.PH. (MANAGING MEMBER, PIC)
(417) 468-4442
Entity
Organization
Contact information
Practice address
483 POMME DE TERRE, MARSHFIELD, MO 65706-2386
(417) 468-4442
(417) 468-4462
Mailing address
483 POMME DE TERRE, MARSHFIELD, MO 65706-2386
(417) 468-4442
(417) 468-4462
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
2004036065
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
626937908
—
MO
Enumeration date
01/22/2007
Last updated
04/29/2011
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