Organization
DALECO INC
Active
Other names
USA CLINIC AT MINERAL AREA HOSPITAL
Organization subpart
No
Provider details
NPI number
Authorized official
GALEN PERKINS (PHARMACY SERVICES COORDINATOR)
(501) 296-3311
Entity
Organization
Contact information
Practice address
1101 WEBER RD, FARMINGTON, MO 63640-3352
(573) 756-6117
(573) 756-5541
Mailing address
1401 S BOULDER AVE, STE 300, TULSA, OK 74119-3647
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
2008035866
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2624941
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
07/07/2005
Last updated
08/21/2012
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