NPIMap

Organization Active NPI

RX Outreach, Inc

  • Community/Retail Pharmacy
  • Dellwood, MO
National Provider Identifier
1114793353
Registry record updated Jul 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
RX OUTREACH, INC
Practice address
10208 W Florissant Ave
Dellwood, MO 63136-2106
Phone
(314) 930-2185
Fax
(314) 930-2186
NPI assigned
Nov 29, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2024

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

Authorized official

Name
Dr. Sergio Barranco-Medina, RPHNPI 1205312261
Title
Chief Pharmacy Officer - Pharmacist
Phone
(314) 477-4532

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

10208 W Florissant Ave
Dellwood, MO 63136-2106

Mailing address

10208 W Florissant Ave
Dellwood, MO 63136-2106
Phone (314) 930-2185

Other names 1

  • RxO Community Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240801000766 MO Part B Supplier - Pharmacy 4385181932 Practice locations: Saint Louis, MO

National Provider Directory

National Provider Directory
Tax ID family
RX Outreach3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

10208 West Florissant Ave
Saint Louis, MO 63136
Phone (314) 930-2185

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1701216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722384000000",
    "number": "1114793353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10208 W FLORISSANT AVE",
            "city": "DELLWOOD",
            "state": "MO",
            "postal_code": "631362106",
            "telephone_number": "314-930-2185",
            "fax_number": "314-930-2186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10208 W FLORISSANT AVE",
            "city": "DELLWOOD",
            "state": "MO",
            "postal_code": "631362106",
            "telephone_number": "314-930-2185",
            "fax_number": "314-930-2186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RX OUTREACH, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-29",
        "last_updated": "2024-07-31",
        "certification_date": "2024-07-31",
        "status": "A",
        "authorized_official_last_name": "BARRANCO-MEDINA",
        "authorized_official_first_name": "SERGIO",
        "authorized_official_title_or_position": "CHIEF PHARMACY OFFICER - PHARMACIST",
        "authorized_official_telephone_number": "314-477-4532",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "RxO Community Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "RxO Community Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.