Individual
MR. JERRY A SCHUPP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
2304 MISSOURI BLVD, JEFFERSON CITY, MO 65109-4729
(573) 634-4400
(573) 636-0672
Mailing address
2304 MISSOURI BLVD, JEFFERSON CITY, MO 65109-4729
(573) 634-4400
(573) 636-0672
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
29259
MO
Other
Enumeration date
02/11/2010
Last updated
02/11/2010
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