Organization · NPI-2
Bjc Behavioral Health
Pharmacy · Farmington, MO
NPI number1114268935
StatusActive
Last updated in NPPESAug 18, 2023
Details
- NPI
- 1114268935
- Entity type
- Organization (NPI-2)
- Legal business name
- Bjc Behavioral Health
- Organization subpart
- Yes
- Enumeration date
- Mar 4, 2013
- Certification date
- Aug 18, 2023
- Last updated
- Aug 18, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 333600000X | Pharmacy | – | – | Yes |
| 251S00000X | Community/Behavioral Health | – | – |
Other names
- Bjc Behavioral Southeast Pharmacy (Doing Business As)
Practice location
1085 Maple StFarmington, MO 63640-1955
Phone 573-756-5353
Mailing address
1085 Maple StFarmington, MO 63640-1955
Phone 573-756-5353
Authorized official
Angela Martin-Davis
President
3142063712
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