Organization
ARCADIA EGO INC
Active
Other names
MITCHELL PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN MITCHELL RPH (OWNER & PIC)
(573) 888-9094
Entity
Organization
Contact information
Practice address
123 1ST ST, KENNETT, MO 63857-2051
(573) 888-9094
(573) 888-5946
Mailing address
123 1ST ST, KENNETT, MO 63857-2051
(573) 888-9094
(573) 888-5946
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
2005035753
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2608149
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
600745400
—
MO
Enumeration date
04/19/2007
Last updated
01/12/2012
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