| NPI | 1639271059 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN GUINN Billing Spec 314-993-6000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Additional Taxonomies | 333600000X Pharmacy (Licence: LA 3816IR) |
| Enumeration Date | 2006-09-05 |
| Last Update Date | 2025-09-11 |