Organization
JONES DRUG STORE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRYAN THOMAS KIEFER RPH (MANAGER / PIC)
(573) 243-3525
Entity
Organization
Contact information
Practice address
125 COURT STREET, JACKSON, MO 63755
(573) 243-3524
(573) 243-2155
Mailing address
PO BOX 494, 125 COURT STREET, JACKSON, MO 63755
(573) 243-3524
(573) 243-2155
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
10119701
MO
332B00000X
Durable Medical Equipment & Medical Supplies
10119701
MO
3336C0003X
Community/Retail Pharmacy
Primary
005586
MO
3336L0003X
Long Term Care Pharmacy
005586
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
600130504
—
MO
05
—
620130500
—
MO
Enumeration date
09/01/2006
Last updated
04/29/2019
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