| NPI | 1104910363 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK JAEGER VP Ambulatory & Specialty Pharmacy 314-628-5607 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: OK 1-6150) |
| Additional Taxonomies | 333600000X Pharmacy |
| 3336C0004X Pharmacy, Compounding Pharmacy | |
| 3336M0002X Pharmacy, Mail Order Pharmacy | |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2021-06-17 |