Organization
GROVE PROFESSIONAL PHARMACY INC.
Active
Other names
Grove Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
GARY GROVE (PRES)
(417) 881-2910
Entity
Organization
Contact information
Practice address
3050 S NATIONAL AVE, STE 109, SPRINGFIELD, MO 65804
(417) 881-2910
(417) 881-3014
Mailing address
1925 S GLENSTONE AVE, SPRINGFIELD, MO 65804
(417) 881-2910
(417) 890-1579
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
003203
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
600309801
—
MO
Enumeration date
10/20/2006
Last updated
09/02/2022
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