MARYVILLE 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

203000877

License Status

CHANGE OF OWNERSHIP

Business

Business Name

MARYVILLE PHARMACY INC

Original Issue Date

02/01/2007

Effective Date

07/09/2018

Expiration Date

03/31/2021

City

MARYVILLE

State

Zip

62062

County

MADISON

Ever Disciplined

LastModifiedDate

12/02/2020