Active NPI
Michael John Sita, R.PH.
- Pharmacist
- Saint Louis, MO
National Provider Identifier
1114200797
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 029435
- Practice address
- 7339 Gravois Ave
Walgreens #3906
Saint Louis, MO 63116-1040 - Phone
- (314) 752-0722
- Fax
- (314) 752-0226
- NPI assigned
- Sep 21, 2011
- Last updated
- Mar 7, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 029435 | MO | Primary |
| Pharmacist | 183500000X | 051031158 | IL |
Addresses
Primary practice location
7339 Gravois Ave
Walgreens #3906
Saint Louis, MO 63116-1040
Mailing address
7339 Gravois Ave
Walgreens #3906
Saint Louis, MO 63116-1040
Phone (314) 752-0722
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 051031158 | IL | MD | Pharmacist |
| 029435 | MO | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1316563200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1114200797",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7339 GRAVOIS AVE",
"address_2": "WALGREENS #3906",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631161040",
"telephone_number": "314-752-0722",
"fax_number": "314-752-0226"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7339 GRAVOIS AVE",
"address_2": "WALGREENS #3906",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631161040",
"telephone_number": "314-752-0722",
"fax_number": "314-752-0226"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SITA",
"first_name": "MICHAEL",
"middle_name": "JOHN",
"name_prefix": "Mr.",
"credential": "R.PH.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-09-21",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MO",
"license": "029435",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IL",
"license": "051031158",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
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 Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.