Organization
GRAHAMS SOUTH SIDE DRUGS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LEROY GRAHAM (PHARMACISR)
(816) 887-5206
Entity
Organization
Contact information
Practice address
103 E MECHANIC ST, HARRISONVILLE, MO 64701-2461
(816) 380-3321
(816) 887-5206
Mailing address
103 E MECHANIC ST, HARRISONVILLE, MO 64701-2461
(816) 380-3321
(816) 887-5206
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
PS004160
MO
Other
Enumeration date
02/13/2007
Last updated
08/22/2020
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