Organization Active NPI

Schnuck Markets Inc

  • Community/Retail Pharmacy
  • Saint Louis, MO
National Provider Identifier
1104331610
Registry record updated Jan 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
SCHNUCK MARKETS INC
Doing business as
Schnucks Diabetes Care Center
Practice address
11550 Page Service Dr Ste 101B
Saint Louis, MO 63146-3531
Phone
(314) 218-3321
Fax
(314) 218-3332
NPI assigned
Dec 6, 2017
Organization subpart
Yes
Parent organization
SCHNUCK MARKETS INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 24, 2019

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

Authorized official

Name
Lisa M Dobbs
Title
Manager of Third Party
Phone
(314) 994-4902

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Diabetes Educator Registered NurseGroup: 193400000X SINGLE SPECIALTY GROUP 163WD0400X
Medical Specialty Clinic/Center 261QM2500X
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

11550 Page Service Dr Ste 101B
Saint Louis, MO 63146-3531

Mailing address

11420 Lackland Rd
Saint Louis, MO 63146-3559
Phone (314) 994-4902

Other names 1

  • Schnucks Diabetes Care Center Doing business as

National Provider Directory

National Provider Directory
Part of
Schnucks Pharmacy 711

Locations

11550 Page Service Dr
Ste 101B
Saint Louis, MO 63146
Phone (314) 218-3321

NPI Registry JSON

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

{
    "created_epoch": "1512518400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1548288000000",
    "number": "1104331610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11420 LACKLAND RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631463559",
            "telephone_number": "314-994-4902",
            "fax_number": "314-994-4586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11550 PAGE SERVICE DR STE 101B",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631463531",
            "telephone_number": "314-218-3321",
            "fax_number": "314-218-3332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCHNUCK MARKETS INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SCHNUCK MARKETS INC",
        "enumeration_date": "2017-12-06",
        "last_updated": "2019-01-24",
        "status": "A",
        "authorized_official_last_name": "DOBBS",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "MANAGER OF THIRD PARTY",
        "authorized_official_telephone_number": "314-994-4902"
    },
    "taxonomies": [
        {
            "code": "163WD0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse, Diabetes Educator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Schnucks Diabetes Care Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Schnucks Diabetes Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2019; 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.