| NAME |
GENE TAYLOR PHARMACY |
| STATE |
MISSOURI |
| STREET ADDR. 1 |
1850 WEST REPUBLIC RD |
| CITY |
SPRINGFIELD |
| ZIP |
65807-5730 |
| STATUS |
National |
| ASSOCIATIONS |
|
| BILLING FACILITY NAME |
SPRINGFIELD MO VA CLINIC PHARMACY |
| EFFECTIVE DATE/TIME |
-
- 2008-05-07 00:00:00
- STATUS: ACTIVE
- NPI: 1659547800
|
| TAXONOMY CODE |
|
| LOCATION TIMEZONE |
CENTRAL |
| COUNTRY |
USA |
| AGENCY CODE |
VA |
| POINTER TO AGENCY |
VA |
| HISTORY |
-
- STREET ADDR. 1 (CHANGED FROM): 1850 WEST REPUBLIC ROAD
- CITY (CHANGED FROM): SPRINGFIELD
- STATE (CHANGED FROM): MISSOURI
- ZIP (CHANGED FROM): 65807-5730
|
