Organization
GPMO, INC
Active
Other names
Grand Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
GREGORY YATES GILMORE R.PH. (OWNER/PHARMACIST)
(573) 221-2792
Entity
Organization
Contact information
Practice address
733 GRAND AVE, HANNIBAL, MO 63401
(573) 221-2792
(573) 221-4468
Mailing address
733 GRAND AVE, HANNIBAL, MO 63401
(573) 221-2792
(573) 221-4468
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
004527
MO
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2050666
PK
—
05
—
602201303
—
MO
Enumeration date
11/15/2006
Last updated
07/01/2024
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