Organization
LAURIE PHARMACY INC
Active
Other names
SENIOR PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
TOM TODD (OWNER)
(573) 378-1916
Entity
Organization
Contact information
Practice address
901 KIDWELL DR STE C, VERSAILLES, MO 65084-1784
(573) 378-1916
(573) 378-5053
Mailing address
901 KIDWELL DR STE C, VERSAILLES, MO 65084-1784
(573) 378-1916
(573) 378-5053
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
2005038678
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2636403
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
07/14/2006
Last updated
02/07/2013
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