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Organization

CLARK COUNTY PHARMACY INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ANTHONY MCKEE (OWNER PHARMACIST)
(660) 727-2214
Entity
Organization

Contact information

Practice address
250 S JOHNSON ST, KAHOKA, MO 63445-1635
(660) 727-2214
(660) 727-2764
Mailing address
250 S JOHNSON ST, KAHOKA, MO 63445-1635
(660) 727-2214
(660) 727-2764

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
333600000X
Pharmacy
3336C0003X
Community/Retail Pharmacy
Primary
004723
MO
3336C0004X
Compounding Pharmacy

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2047958
PK
05
600119309
MO
05
620119305
MO
Enumeration date
02/21/2007
Last updated
10/14/2021
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