Laila Ait Haj Kaddour

Individual provider Active NPI Pharmacist · Saint Louis, MO

NPI 1043989205 · NPPES record last updated Feb 22, 2024

Key facts

NPI
1043989205
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacist 183500000X
License
2021036761 (MO)
Practice address
1 Barnes Jew Hosp PLZ
Saint Louis, MO 63110-1003
Phone
(314) 362-5339
NPI assigned
Sep 10, 2021
Sex
Female
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
2021036761MOMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co Past
since Sep 1, 2021
Accepting new patients
Walgreen Co Past
since Sep 1, 2021
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 2021036761 MO Yes

Addresses

Primary practice location

1 Barnes Jew Hosp PLZ
Saint Louis, MO 63110-1003

Mailing address

1 Barnes Jew Hosp PLZ
Saint Louis, MO 63110-1003
Phone (314) 362-5339

Other providers in Saint Louis, MO

All providers in Saint Louis, MO · Pharmacist in Missouri

Sources for this page

Verify at the official NPI Registry.