Organization
CITY PBA PHARMACY
Active
Other names
CITY PBA PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN MARKOVICH PD (OWNER PRESSIDENT)
(660) 529-2255
Entity
Organization
Contact information
Practice address
227 MAIN ST, SLATER, MO 65349-1411
(660) 529-2255
(660) 529-2701
Mailing address
227 MAIN ST, SLATER, MO 65349-1411
(660) 529-2255
(660) 529-2701
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
003919
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2048676
PK
—
05
—
600095418
—
MO
Enumeration date
07/14/2006
Last updated
12/18/2016
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