Organization
WRINKLE'S PHARMACY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TOM GLENSKI (SECRETARY)
(816) 238-4522
Entity
Organization
Contact information
Practice address
5409 LAKE AVE, SAINT JOSEPH, MO 64504-1439
(816) 238-4522
Mailing address
6210 NW COGDILL RD, KING CITY, MO 64463-9247
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
002729
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2603074
NABP/NACDS
—
Enumeration date
11/12/2005
Last updated
11/05/2016
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