Washington University

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

2012041103 Issued in MO

Legal business name

WASHINGTON UNIVERSITY

Doing business as

Washington University Cancer Center Pharmacy-South County

Practice address

5225 Midamerica PLZ
Saint Louis, MO 63129-0002

Phone

(314) 286-1929

Fax

(314) 286-1788

NPI assigned

Dec 24, 2012

Organization subpart

No

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

Authorized official

Name

Byron Peters

Title

Pharmacy Director

Phone

(314) 747-2472

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Washington University Cancer Center Pharmacy-South County Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1356307200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1356307200000",
    "number": "1104162999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5225 MIDAMERICA PLZ",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631290002",
            "telephone_number": "314-286-1929",
            "fax_number": "314-286-1788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5225 MIDAMERICA PLZ",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631290002",
            "telephone_number": "314-286-1929",
            "fax_number": "314-286-1788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WASHINGTON UNIVERSITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-24",
        "last_updated": "2012-12-24",
        "status": "A",
        "authorized_official_last_name": "PETERS",
        "authorized_official_first_name": "BYRON",
        "authorized_official_title_or_position": "PHARMACY DIRECTOR",
        "authorized_official_telephone_number": "314-747-2472"
    },
    "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": "2012041103",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "2640806",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Washington University Cancer Center Pharmacy-South County",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Washington University (Clinical Cytogenetics Laboratory)
• Washington University (Pediatric Otolaryngology)
• Washington University
• Washington University
• Washington University (Pediatric Otolaryngology)
• Washington University
• Washington University (Center for Advanced Medicine)
• Washington University
• Washington University
• Washington University (Center for Advanced Medicine)

• 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 Dec 24, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.

Verify at the official NPI Registry.