Organization
CURATORS OF THE UNIVERSITY OF MISSOURI
Active
Other names
MIZZOU PHARMACY - FAIRVIEW
Organization subpart
No
Provider details
NPI number
Authorized official
FREDERIC A. RANSOM (CEO)
(573) 884-0054
Entity
Organization
Contact information
Practice address
101 S FAIRVIEW RD, COLUMBIA, MO 65203-7637
(573) 884-8307
(573) 884-4773
Mailing address
PO BOX 843310, KANSAS CITY, MO 64184-3310
(573) 884-8307
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
6152
MO
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2047657
PK
—
05
—
608897203
—
MO
Enumeration date
08/11/2006
Last updated
06/29/2023
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