| NPI | 1740648476 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALICIA B BARISHMAN Registered Pharmacist 314-972-2259 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: MO PH044156) |
| Additional Taxonomies | 333600000X Pharmacy (Licence: FL PS30150) |
| Enumeration Date | 2016-02-09 |
| Last Update Date | 2016-02-09 |