Organization
SAINT-MARK ENTERPRISES 106 LLC
Active
Other names
MEDICINE SHOPPE
Organization subpart
No
Provider details
NPI number
Authorized official
MARK A MILLER (OWNER)
(314) 518-2427
Entity
Organization
Contact information
Practice address
207 PROFESSIONAL WAY, SHELTON, WA 98584-4404
(360) 426-4272
(360) 426-6977
Mailing address
PO BOX 98, EUREKA, MO 63025-0098
(314) 518-2427
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6032221
—
WA
Enumeration date
03/03/2009
Last updated
06/30/2009
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