| NPI | 1467494062 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA RENEE CLABON Chief Executive Officer 314-367-5820 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0002X Pharmacy, Clinic Pharmacy (Licence: MO 2005035950) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 333600000X Pharmacy | |
| 3336M0002X Pharmacy, Mail Order Pharmacy | |
| 335E00000X Prosthetic/Orthotic Supplier | |
| Enumeration Date | 2006-06-11 |
| Last Update Date | 2020-09-14 |