Organization
NUTRITIONAL SUPPORT SERVICES
Active
Other names
NETWORK HEALTHCARE MISSOURI
Organization subpart
No
Provider details
NPI number
Authorized official
TERRY LEEMAN (PRESIDENT)
(615) 890-2020
Entity
Organization
Contact information
Practice address
1329 HORAN DR, FENTON, MO 63026-1939
(636) 779-2700
(636) 779-2704
Mailing address
PO BOX 32249, KNOXVILLE, TN 37930-2249
Taxonomy
Speciality
Code
Description
License number
State
3336I0012X
Institutional Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
2004034239
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2049057
PK
—
05
—
606172203
—
MO
Enumeration date
07/22/2006
Last updated
01/28/2020
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