St Anthonys Professional Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

2000160057 Issued in MO

Legal business name

ST ANTHONYS PROFESSIONAL PHARMACY LLC

Doing business as

St Anthonys Retail Pharmacy

Practice address

10004 Kennerly Rd
Suite 130
Saint Louis, MO 63128-2141

Phone

(314) 525-4777

Fax

(314) 525-4642

NPI assigned

Jun 22, 2006

Last updated

Mar 14, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ken Venuto, RPH

Title

Cfo

Phone

(314) 525-7340

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• ST ANTHONYS RETAIL PHARMACY Doing business as

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Mercy Hospital South

  dba Mercy Home Health

  • Home Health Agency
  • Saint Louis, MO
  • NPI 1053314179

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1150934400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1457913600000",
    "number": "1053357566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12700 SOUTHFORK RD",
            "address_2": "SUITE 110",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631283201",
            "telephone_number": "314-525-4488",
            "fax_number": "314-525-4810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10004 KENNERLY RD",
            "address_2": "SUITE 130",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631282141",
            "telephone_number": "314-525-4777",
            "fax_number": "314-525-4642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST ANTHONYS PROFESSIONAL PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-22",
        "last_updated": "2016-03-14",
        "status": "A",
        "authorized_official_last_name": "VENUTO",
        "authorized_official_first_name": "KEN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "314-525-7340",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MO",
            "license": "2000160057",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "600307409",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2047126",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ST ANTHONYS RETAIL PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Saint Louis, MO
• Providers in Saint 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 Mar 14, 2016; 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.