NPI: 1326150327 · MONTGOMERY CITY, MO 63361 · Long Term Care Pharmacy · NPI assigned 08/31/2006
| Authorized Official | WANG, JASON (VICE PRESIDENT) |
| NPI Enumeration Date | 08/31/2006 |
Other providers sharing the same authorized official: WANG, JASON
| Provider | City | State | Total Paid |
|---|---|---|---|
| DESERT PEDIATRICS, LLC | EL PASO | TX | $97K |
| PEVELY RX | PEVELY | MO | $56K |
| TOMLYN, INC | AFFTON | MO | $55K |
| Year | Claims | Total Paid |
|---|---|---|
| 2023 | 12 | $900.00 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 99605 | 12 | 12 | $900.00 |