Organization
LANDRUM DRUG INC
Active
Other names
LANDRUM DRUG
Organization subpart
No
Provider details
NPI number
Authorized official
JILL FREITAS RPH (OWNER/PIC/SECRETARY)
(417) 461-1100
Entity
Organization
Contact information
Practice address
106 E MOUNT VERNON BLVD, MOUNT VERNON, MO 65712-2040
(417) 461-1100
(417) 461-1103
Mailing address
106 E MOUNT VERNON BLVD, MOUNT VERNON, MO 65712-2040
(417) 461-1100
(417) 461-1103
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
2008012584
MO
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1821264433
—
MO
01
—
2049640
PK
—
Enumeration date
05/03/2008
Last updated
07/07/2022
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