Organization
FOUR STATES APOTHECARY LLC
Active
Other names
CJ Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK STEVEN MAYBERRY JR. PHARMD (PHARMACY OWNDER)
(417) 529-1815
Entity
Organization
Contact information
Practice address
102 S MAIN ST, CARL JUNCTION, MO 64834-1000
(417) 649-7021
(417) 649-6269
Mailing address
413 COMMERCIAL ST, OSWEGO, KS 67356-2017
(620) 795-2233
(620) 795-4910
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Enumeration date
10/05/2018
Last updated
10/05/2018
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