NPI 1144505447

Si03, INC.

Organisation Medical Foods Supplier Scott City, MO

Practice location

Address: 4711 Nash Road, Scott City, MO 63780
Phone: (573) 388-2301
Fax: (573) 388-2308
Mailing address: PO Box 1715, Cape Girardeau, MO 63702

Authorised official

Name: Jeff Fanger
Title: General Manager
Phone: (573) 388-2301

Registered specialties

Medical Foods Supplier Primary

Suppliers Taxonomy 335G00000X

Other Medical Foods Supplier providers in Missouri →

Registry record

NPI: 1144505447
Entity type: Organization
NPI issued: 18 Oct 2011
Record last updated: 18 Oct 2011

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.