Individual
DONALD WAYNE GROVE JR.
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
1330 COMMERCIAL, WARSAW, MO 65355
(660) 438-7331
(660) 438-6168
Mailing address
32449 BARCLAY LOOP, WARSAW, MO 65355
(660) 438-9051
(660) 438-6168
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
028136
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
028136
MO PHARMACY LICENSE NUMBE
MO
Enumeration date
10/11/2005
Last updated
07/08/2007
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