Organization
TOWN & COUNTRY SUPER MARKET INC
Active
Other names
Country Mart Pharmacy #2425
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JANET L GOTT RPH (PHARMACY DIRECTOR)
(573) 729-4091
Entity
Organization
Contact information
Practice address
43 EAST HIGHWAY 8, STEELVILLE, MO 65565
(573) 775-4666
(573) 775-3393
Mailing address
1204 E HIGHWAY 32, PO BOX 748, SALEM, MO 65560-2844
(573) 729-4091
(573) 729-2394
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
006587
MO
3336C0003X
Community/Retail Pharmacy
Primary
200539822
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
604623405
—
MO
05
—
624623401
—
MO
Enumeration date
11/08/2005
Last updated
12/04/2012
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