Organization
SOUTHEAST HOSPITAL
Active
Other names
MERCY PHARMACY JACKSON
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KRISTA BERRY (CFO)
(573) 331-6028
Entity
Organization
Contact information
Practice address
2600 E. MAIN STREET, SUITE 113, JACKSON, MO 63755
(573) 755-2315
(573) 519-4676
Mailing address
2600 E. MAIN STREET, SUITE 113, JACKSON, MO 63755
(573) 755-2315
(573) 519-4676
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
3336L0003X
Long Term Care Pharmacy
—
—
Other
Enumeration date
12/04/2019
Last updated
03/05/2024
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