Organization
SAULTS DRUG STORE INC
Active
Other names
SAULTS DRUG STORE INC
Organization subpart
No
Provider details
NPI number
Authorized official
ALTON REAL RPH (OWNER,RPH,AO)
(573) 642-4186
Entity
Organization
Contact information
Practice address
505 COURT ST, FULTON, MO 65251-1901
(573) 642-4186
(573) 642-8324
Mailing address
505 COURT ST, FULTON, MO 65251-1901
(573) 642-4186
(573) 642-8324
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
004787
MO
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2048868
PK
—
05
—
600053409
—
MO
Enumeration date
08/10/2006
Last updated
03/20/2017
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