Organization
SAINT-MARK ENTERPRISES 1906 LLC
Active
Other names
MEDICINE SHOPPE
Organization subpart
No
Provider details
NPI number
Authorized official
MARK A MILLER (OWNER)
(314) 518-2427
Entity
Organization
Contact information
Practice address
2125 COLLEGE AVE STE 1, CONWAY, AR 72034-6387
(501) 327-8088
Mailing address
PO BOX 98, EUREKA, MO 63025-0098
(314) 518-2427
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0423070
NCPDP #
—
05
—
175902407
—
AR
Enumeration date
01/07/2009
Last updated
06/10/2009
Update your record
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