NPI 1164704516

Henry Irvin, PHARMD

Practitioner Pharmacist Branson, MO

Practice location

Address: 610 S 6th St, Branson, MO 65616-2843
Phone: (417) 336-9355
Fax: (417) 334-4427
Mailing address: 250 Teepee Lane, Kimberling City, MO 65686

Registered specialties

Pharmacist Primary

Pharmacy Service Providers Taxonomy 183500000X Licence 2006038096 (MO)

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Registry record

NPI: 1164704516
Entity type: Individual
Sex (as registered): Male
NPI issued: 12 Sep 2011
Record last updated: 23 Aug 2022

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.