MT VERNON COMMUNITY PHARMACY INC HME and Services Provider License verification

Business Entity

CHANGE OF OWNERSHIP

License Type

HME and Services Provider

Description

HOME MEDICAL EQUIPMENT AND SERVICES PROVIDER

License Number

203000346

License Status

CHANGE OF OWNERSHIP

Business

Business Name

MT VERNON COMMUNITY PHARMACY INC

BusinessDBA

THE MEDICINE SHOPPE

Original Issue Date

02/20/2002

Effective Date

03/02/2009

Expiration Date

03/31/2012

City

MOUNT VERNON

State

Zip

62864

County

JEFFERSON

Ever Disciplined

LastModifiedDate

03/17/2010