Organization
MIKE STUART ENTERPRISES INC
Active
Other names
LAKELAND PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL STUART RPH (OWNER)
(417) 272-8064
Entity
Organization
Contact information
Practice address
18565 BUSINESS 13, BRANSON WEST, MO 65737-9659
(417) 272-8064
(417) 272-0073
Mailing address
18565 BUSINESS 13, BRANSON WEST, MO 65737-9659
(417) 272-8064
(417) 272-0073
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
006432
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2047744
PK
—
05
—
603758806
—
MO
Enumeration date
12/13/2006
Last updated
04/23/2024
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