Organization
SOUTHEAST HOSPITAL
Active
Other names
MERCY PHARMACY S MOUNT AUBURN
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTA BERRY (CFO)
(573) 331-6028
Entity
Organization
Contact information
Practice address
817 S MOUNT AUBURN RD STE 130, CAPE GIRARDEAU, MO 63703-6392
(573) 519-4550
(573) 519-4590
Mailing address
817 S MOUNT AUBURN RD STE 130, CAPE GIRARDEAU, MO 63703-6392
(573) 519-4550
(573) 519-4590
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
2010038132
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2127617
PK
—
Enumeration date
11/03/2010
Last updated
03/05/2024
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