Organization
ADVANTAGE PHARMACY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CONNIE JEAN BLACKFORD RN (MEMBER, MANAGER)
(816) 918-6467
Entity
Organization
Contact information
Practice address
301 E PRICE AVE STE B, SAVANNAH, MO 64485-2482
(816) 324-1229
(816) 326-9012
Mailing address
301 E PRICE AVE STE B, SAVANNAH, MO 64485-2482
(816) 324-1229
(816) 326-9012
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
2007016458
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2007016458
MO PHARMACY LICENSE NUM
MO
Enumeration date
06/13/2007
Last updated
06/23/2008
Update your record
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