NPIMap

Organization Active NPI

SSM Health Care St. Louis

Doing business as SSM Health Pharmacy

  • Community/Retail Pharmacy
  • St. Chalres, MO
National Provider Identifier
1164581526
Registry record updated Oct 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
005663 Issued in MO
Legal business name
SSM HEALTH CARE ST. LOUIS
Doing business as
SSM Health Pharmacy
Practice address
711 Veterans Memorial Parkway Suite 102
St. Chalres, MO 63303-2106
Phone
(636) 669-2223
Fax
(636) 669-2222
NPI assigned
Dec 8, 2006
Last updated
Oct 18, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2022

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

Authorized official

Name
Kimberly Spencer
Title
V.P. Pharmacy Services
Phone
(314) 989-2588

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 005663 MO Primary

Addresses

Primary practice location

711 Veterans Memorial Parkway Suite 102
St. Chalres, MO 63303-2106

Mailing address

711 Veterans Memorial Parkway Suite 102
St. Charles, MO 63303
Phone (636) 443-2406

Other names 1

  • SSM Health Pharmacy Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230509001911 MO Part B Supplier - Pharmacy 7810800737 4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Wentzville, MO; Saint Louis, MO; Saint Charles, MO; Bridgeton, MO

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Sterkel Hogan Spiro Gui18 organizations share this tax ID, including this one

Other organizations with this tax ID 17

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

View all 17

Locations

711 Veterans Memorial Pkwy
Ste 102
Saint Charles, MO 63303
Phone (636) 669-2200

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1165536000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666051200000",
    "number": "1164581526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 VETERANS MEMORIAL PARKWAY SUITE 102",
            "city": "ST. CHARLES",
            "state": "MO",
            "postal_code": "63303",
            "telephone_number": "636-443-2406",
            "fax_number": "636-669-2222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 VETERANS MEMORIAL PARKWAY SUITE 102",
            "city": "ST. CHALRES",
            "state": "MO",
            "postal_code": "633032106",
            "telephone_number": "636-669-2223",
            "fax_number": "636-669-2222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SSM HEALTH CARE ST. LOUIS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-08",
        "last_updated": "2022-10-18",
        "certification_date": "2022-10-18",
        "status": "A",
        "authorized_official_last_name": "SPENCER",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "V.P. PHARMACY SERVICES",
        "authorized_official_telephone_number": "314-989-2588"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MO",
            "license": "005663",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SSM Health 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 Oct 18, 2022; 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.