Organization
KOERBLES PHARMACY INC
Active
Other names
GEORGE'S PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
JIM MONTGOMERY (PRESIDENT)
(417) 889-7898
Entity
Organization
Contact information
Practice address
3650 E SUNSHINE ST, SPRINGFIELD, MO 65809-2820
(417) 889-7898
(417) 889-0018
Mailing address
3650 E SUNSHINE ST, SPRINGFIELD, MO 65809-2820
(417) 889-7898
(417) 889-0018
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
005962
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2126855
PK
—
05
—
607979903
—
MO
Enumeration date
04/21/2006
Last updated
11/06/2013
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