| NPI | 1518272673 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELINDA CORLEY Pharmacist In Charge 314-996-3403 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: MO 2010026615) |
| Enumeration Date | 2010-08-13 |
| Last Update Date | 2017-11-01 |