Active NPI
Millbrook Pharmacy, Inc
- Community/Retail Pharmacy
- University City, MO
National Provider Identifier
1033519251
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- Legal business name
- MILLBROOK PHARMACY, INC
- Practice address
- 7010 Pershing Ave
University City, MO 63130-4318 - Phone
- (314) 993-4031
- NPI assigned
- Aug 25, 2014
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Richard S Williams
- Title
- Pres
- Phone
- (314) 993-4031
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | Primary |
Addresses
Primary practice location
7010 Pershing Ave
University City, MO 63130-4318
Mailing address
9832 Clayton Rd
Saint Louis, MO 63124-1604
Phone (314) 993-4031
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20150422001185 | MO | Part B Supplier - Mass Immunization (Roster Biller Only) | 2567780661 | Practice locations: St Louis, MO |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 26D2093187 | Millbrook Pharmacy Inc | Certificate of waiver | Mar 22, 2027 |
National Provider Directory
National Provider DirectoryMember of 1
Organizations this organization is a member of, according to the National Provider Directory.
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Pharmacist
- Saint Louis, MO
- NPI 1801252606
-
- Pharmacist
- University City, MO
- NPI 1740719988
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1408924800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1408924800000",
"number": "1033519251",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9832 CLAYTON RD",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631241604",
"telephone_number": "314-993-4031"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7010 PERSHING AVE",
"city": "UNIVERSITY CITY",
"state": "MO",
"postal_code": "631304318",
"telephone_number": "314-993-4031"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MILLBROOK PHARMACY, INC",
"organizational_subpart": "NO",
"enumeration_date": "2014-08-25",
"last_updated": "2014-08-25",
"status": "A",
"authorized_official_last_name": "WILLIAMS",
"authorized_official_first_name": "RICHARD",
"authorized_official_middle_name": "S",
"authorized_official_title_or_position": "PRES",
"authorized_official_telephone_number": "314-993-4031"
},
"taxonomies": [
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in University City, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.