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Organization

COMMUNITY PHARMACY, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. LORI MARIE BARTLETT R.PH (PHARMACIST IN CHARGE/MANAGER)
(417) 667-6044
Entity
Organization

Contact information

Practice address
900 S ADAMS ST, NEVADA, MO 64772-3210
(417) 667-6044
(417) 667-0544
Mailing address
900 S ADAMS ST, NEVADA, MO 64772-3210
(417) 667-6044
(417) 667-0544

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
044158
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100430670B
KS
05
600447304
MO
Enumeration date
11/09/2005
Last updated
02/13/2012
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