| NPI | 1194917773 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEE ERIC ORI President 314-991-5200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0004X Pharmacy, Compounding Pharmacy (Licence: MO 2003001140) |
| Additional Taxonomies | 3336S0011X Pharmacy, Specialty Pharmacy (Licence: MO 2003001140) |
| Enumeration Date | 2007-08-16 |
| Last Update Date | 2007-08-16 |