Active NPI
Jeffrey Juang
- Pharmacist
- Creve Coeur, MO
National Provider Identifier
1154066678
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 2021050359
- Practice address
- 10941 Olive Blvd
Creve Coeur, MO 63141-7740 - Phone
- (314) 997-0555
- NPI assigned
- Apr 29, 2022
- Last updated
- Apr 29, 2022
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 2021050359 | MO | Primary |
Addresses
Primary practice location
10941 Olive Blvd
Creve Coeur, MO 63141-7740
Mailing address
10941 Olive Blvd
Creve Coeur, MO 63141-7740
Phone (314) 997-0555
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2021050359 | MO | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Current | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Locations
10941 Olive Blvd
Saint Louis, MO 63141
Phone (314) 997-0555
Organizations & group practices 2
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": "1651190400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1651190400000",
"number": "1154066678",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10941 OLIVE BLVD",
"city": "CREVE COEUR",
"state": "MO",
"postal_code": "631417740",
"telephone_number": "314-997-0555"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10941 OLIVE BLVD",
"city": "CREVE COEUR",
"state": "MO",
"postal_code": "631417740",
"telephone_number": "314-997-0555"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JUANG",
"first_name": "JEFFREY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-04-29",
"last_updated": "2022-04-29",
"certification_date": "2022-04-29",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MO",
"license": "2021050359",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Creve Coeur, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.