VANDIVORT DRUG
Suppliers at 4 St, Doss, MO

License number
Missouri PS 004855
Category
Suppliers
Type
Community/Retail Pharmacy
Owner
Name: MR. SHERMAN R ODOM RPH
Title: OWNER
Phone: (573) 729-4114
Address
Address
117 W 4Th St, Doss, MO 65560
National Provider ID: 1225072093
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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VANDIVORT DRUG, INC

Doss, MO

Status:
Inactive
Industry:
Ret Drugs/Sundries
Doing business as:
VANDIVORT DRUG
Registration:
Oct 2, 1986
Inactive since:
Aug 28, 2009
Phone:
(573) 729-4114 (Phone)
Addresses:
117 W 4 St, Salem, MO 65560 (Physical)
101 E 4 St, Salem, MO 65560 (Physical)
State ID:
00293963
Business type:
Gen. Business - For Profit
Expiration:
Perpetual
Pharmacists:
Sherman R. Odom (Owner, Pharmacist),Mickie D. Nichols (Pharmacist)

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