Organization
GOSNEY LTC
Active
Other names
Gosney Long Term Care
Organization subpart
No
Provider details
NPI number
Authorized official
JORDAN GOSNEY (OWNER)
(573) 629-1506
Entity
Organization
Contact information
Practice address
2902 SAINT MARYS AVE, HANNIBAL, MO 63401-3715
(573) 629-1506
(888) 659-4710
Mailing address
PO BOX 911, HANNIBAL, MO 63401-0911
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0004X
Compounding Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
2014000958
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2143790
PK
—
Enumeration date
01/13/2014
Last updated
09/16/2016
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