NPIMap

Organization Active NPI

Christian Hospital Northeast Northwest

Doing business as Family Care Pharmacy at Graham Medical Center

  • Community/Retail Pharmacy
  • Florissant, MO
National Provider Identifier
1144336058
Registry record updated Sep 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PS005673 Issued in MO
Legal business name
CHRISTIAN HOSPITAL NORTHEAST NORTHWEST
Doing business as
Family Care Pharmacy at Graham Medical Center
Practice address
1224 Graham Rd
Florissant, MO 63031-8028
Phone
(314) 953-6740
Fax
(314) 953-6921
NPI assigned
Aug 22, 2006
Last updated
Sep 6, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2012

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

Authorized official

Name
Mary Wehking
Title
Supervisor
Phone
(314) 953-6740

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X NU
Community/Retail Pharmacy 3336C0003X PS005673 MO Primary

Addresses

Primary practice location

1224 Graham Rd
Florissant, MO 63031-8028

Mailing address

1224 Graham Rd
Florissant, MO 63031-8028
Phone (314) 953-6740

Other identifiers 2

IdentifierTypeStateIssuer
2625424OtherNCPDP PROVIDER IDENTIFICATION NUMBER
606763506MedicaidMO

Other names 1

  • Family Care Pharmacy at Graham Medical Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Network Reference Lab7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

NPI Registry JSON

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

{
    "created_epoch": "1156204800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1346889600000",
    "number": "1144336058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1224 GRAHAM RD",
            "city": "FLORISSANT",
            "state": "MO",
            "postal_code": "630318028",
            "telephone_number": "314-953-6740",
            "fax_number": "314-953-6921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1224 GRAHAM RD",
            "city": "FLORISSANT",
            "state": "MO",
            "postal_code": "630318028",
            "telephone_number": "314-953-6740",
            "fax_number": "314-953-6921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRISTIAN HOSPITAL NORTHEAST NORTHWEST",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-22",
        "last_updated": "2012-09-06",
        "status": "A",
        "authorized_official_last_name": "WEHKING",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "SUPERVISOR",
        "authorized_official_telephone_number": "314-953-6740"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MO",
            "license": "PS005673",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "2625424",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "606763506",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Care Pharmacy at Graham Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Florissant, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2012; 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.