Organization
SAINT-MARK ENTERPRISES 1788 LLC
Active
Other names
MEDICINE SHOPPE
Organization subpart
No
Provider details
NPI number
Authorized official
MARK A MILLER (OWNER)
(314) 518-2427
Entity
Organization
Contact information
Practice address
11 E H ST, SUITE A, DEER PARK, WA 99006-7178
(509) 276-5081
Mailing address
PO BOX 98, EUREKA, MO 63025-0098
(509) 276-5081
(509) 276-7653
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6032213
—
WA
Enumeration date
03/03/2009
Last updated
06/30/2009
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