| NPI | 1437264470 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAM BAE Owner 314-367-3009 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: MO 2002009522) |
| Additional Taxonomies | 333600000X Pharmacy |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| 3336L0003X Pharmacy, Long Term Care Pharmacy | |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2018-03-17 |