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Individual

DR. NICOLE MCHARGUE NEAL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PHARMD

Contact information

Practice address
403 S MAIN ST, GALLATIN, MO 64640-1434
(660) 663-7979
(660) 663-2963
Mailing address
403 S MAIN ST, GALLATIN, MO 64640-1434
(660) 663-7979

Taxonomy

Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
2019013549
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
045026
MISSOURI STATE BOARD OF PHARMACY PHARMACIST LICENSE
MO
01
2019013549
MISSOURI STATE BOARD OF PHARMACY PERMIT
MO
01
2500053920
BNDD LICENSE
MO
Enumeration date
04/26/2019
Last updated
04/26/2019
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