Organization
NUTS INC
Active
Other names
MARIONVILLE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN TONJUK RPH (PIC)
(417) 258-2626
Entity
Organization
Contact information
Practice address
201 S HIGHWAY 60, MARIONVILLE, MO 65705-9407
(417) 258-2526
(417) 463-2211
Mailing address
PO BOX 217, MARIONVILLE, MO 65705-0217
(417) 258-2526
(417) 462-2211
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
005757
MO
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2047195
PK
—
05
—
601199508
—
MO
Enumeration date
10/25/2006
Last updated
12/01/2016
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