Organization
C & P ALTON VENTURES LLC
Active
Other names
Alton Drug store
Organization subpart
No
Provider details
NPI number
Authorized official
REBECCA WALTERS-PEACE (RPH/CO-OWNER)
(417) 778-6807
Entity
Organization
Contact information
Practice address
201 STATE HWY 19, ALTON, MO 65606
(417) 778-7000
(417) 778-7005
Mailing address
450 COUNTY ROAD 139, ALTON, MO 65606-8221
(417) 778-6807
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
2016031074
MO
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2163778
PK
—
05
—
600035662
—
MO
Enumeration date
08/26/2016
Last updated
11/24/2023
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