Organization
MITCHELL PHARMACY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BYRON KEITH MITCHELL RPH (PRESIDENT)
(573) 888-9094
Entity
Organization
Contact information
Practice address
123 1ST ST, KENNETT, MO 63857-2051
(573) 888-9094
(573) 888-5946
Mailing address
PO BOX 143, KENNETT, MO 63857-0143
(573) 888-9094
(573) 888-5946
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
154385
BCBS
MO
Enumeration date
09/17/2006
Last updated
08/22/2020
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