Aetna Rx Home Delivery, LLC - (Pharmacy)
Edward S. Alviso, Jr, PIC
Kansas City, MO 64153
License# : 2003001979 - Issued on : 1/28/2003
Doing Business As : Aetna Rx Home Delivery
| Licensee Name: | Aetna Rx Home Delivery, LLC |
| Profession Name: | Pharmacy |
| Licensee Number: | 2003001979 |
| Expiration Date: | 10/31/2015 |
| Original Issue Date: | 1/28/2003 |
| Address: | Edward S. Alviso, Jr, PIC |
| Address Con't: | 10991 North West Airworld Drive |
| City, State Zip: | Kansas City, MO 64153 |
| County: | Platte |
| Practitioner DBA Name: | Aetna Rx Home Delivery |
| Classification: | Class A, J |
| Current Discipline Status: | None |
Board of Pharmacy
3605 Missouri Boulevard
P.O. Box 625
Jefferson City, MO 65102-0625
573.751.0091 Telephone
573.526.3464 Fax
800.735.2966 TTY
800.735.2466 Voice Relay
MissouriBOP@pr.mo.gov
http://pr.mo.gov/pharmacists
