Dierbergs Markets Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

DIERBERGS MARKETS INC

Practice address

12595 Olive Street Road
St Louis, MO 63141

Phone

(314) 542-2194

Fax

(636) 530-3015

NPI assigned

Oct 13, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Gregory Guenther

Title

Director of Pharmacy

Phone

(636) 812-1470

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• DIERBERGS HERITAGE PHARMACY Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1233273600000",
    "number": "1003906041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1070",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630061070",
            "telephone_number": "636-812-1470",
            "fax_number": "636-812-1603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12595 OLIVE STREET ROAD",
            "city": "ST LOUIS",
            "state": "MO",
            "postal_code": "63141",
            "telephone_number": "314-542-2194",
            "fax_number": "636-530-3015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIERBERGS MARKETS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-13",
        "last_updated": "2009-01-30",
        "status": "A",
        "authorized_official_last_name": "GUENTHER",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_title_or_position": "DIRECTOR OF PHARMACY",
        "authorized_official_telephone_number": "636-812-1470"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "MO",
            "license": "005059",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "2626123",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "603682105",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DIERBERGS HERITAGE PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Annette Lynn Diekmann, PTA
• David P Diemer, MD
• Kathryn M Diemer, MD
• Karen Faye Diemert, MSW, ACSW, LCSW
• Paige Benten Diepenbrock, OD
• Dierbergs Markets Inc
• Dierbergs Markets Inc
• Dierbergs Markets Inc
• Dierbergs Markets Inc
• Dierbergs Markets Inc

• Community/Retail Pharmacy in St Louis, MO
• Providers in St Louis, MO by specialty
• Community/Retail Pharmacy in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.