NPI: 1912062340 · CAPE GIRARDEAU, MO 63701 · Pharmacy · NPI assigned 12/26/2006
| Authorized Official | TALLY, BENJAMIN (OWNER PHARMACIST) |
| NPI Enumeration Date | 12/26/2006 |
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 63 | $9K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| T2029 | Specialized medical equipment, not otherwise specified, waiver | 63 | 63 | $9K |