| NPI | 1316019110 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENA FERMAN Third Party Plan COO Rdinator 314-993-6000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Additional Taxonomies | 333600000X Pharmacy (Licence: TX 17002) |
| Enumeration Date | 2006-11-15 |
| Last Update Date | 2023-03-07 |