Provider Demographics
NPI:1265719264
Name:COUNTS, DAVID E (RPH)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:E
Last Name:COUNTS
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 EAST BROADWAY BLVD
Mailing Address - Street 2:
Mailing Address - City:SEDALIA
Mailing Address - State:MO
Mailing Address - Zip Code:65301
Mailing Address - Country:US
Mailing Address - Phone:660-826-5087
Mailing Address - Fax:660-829-2273
Practice Address - Street 1:100 EAST BROADWAY BLVD
Practice Address - Street 2:
Practice Address - City:SEDALIA
Practice Address - State:MO
Practice Address - Zip Code:65301
Practice Address - Country:US
Practice Address - Phone:660-826-5087
Practice Address - Fax:660-829-2273
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-04
Last Update Date:2023-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO043122183500000X
MO043112183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist