Organization
FRED'S OF DONIPHAN, INC
Active
Parent organization
FRED'S OF DONIPHAN, INC
Other names
Super Saver Pharmacy
Organization subpart
Yes
Provider details
NPI number
Legal business name
FRED'S OF DONIPHAN, INC
Authorized official
CLAYTON JAMISON (OWNER)
(573) 996-3953
Entity
Organization
Contact information
Practice address
100 H&S DRIVE, DONIPHAN, MO 63935
(573) 996-5220
(573) 996-3790
Mailing address
PO BOX 337, DONIPHAN, MO 63935-0337
(573) 996-3953
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
11/15/2017
Last updated
07/08/2019
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