Provider Demographics
NPI:1336995109
Name:MIKE STUART ENTERPRISES, INC.
Entity Type:Organization
Organization Name:MIKE STUART ENTERPRISES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:A
Authorized Official - Last Name:KNEBEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:417-272-0471
Mailing Address - Street 1:18565 BUSINESS 13
Mailing Address - Street 2:
Mailing Address - City:BRANSON WEST
Mailing Address - State:MO
Mailing Address - Zip Code:65737-9659
Mailing Address - Country:US
Mailing Address - Phone:417-272-0471
Mailing Address - Fax:
Practice Address - Street 1:16269 US HIGHWAY 160
Practice Address - Street 2:
Practice Address - City:FORSYTH
Practice Address - State:MO
Practice Address - Zip Code:65653-7122
Practice Address - Country:US
Practice Address - Phone:417-546-5151
Practice Address - Fax:417-546-4591
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-24
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy