Dierbergs Markets Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

DIERBERGS MARKETS INC

Practice address

421 Lafayette Ctr
Ballwin, MO 63011-3943

Phone

(636) 591-0600

Fax

(636) 530-3004

NPI assigned

Oct 12, 2006

Organization subpart

No

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

Authorized official

Name

Gregory Guenther

Title

Director of Pharmacy

Phone

(636) 812-1470

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• DIERBERGS LAFAYETTE PHARMACY Doing business as

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1233273600000",
    "number": "1174612840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1070",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630061070",
            "telephone_number": "636-812-1470",
            "fax_number": "636-812-1603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "421 LAFAYETTE CTR",
            "city": "BALLWIN",
            "state": "MO",
            "postal_code": "630113943",
            "telephone_number": "636-591-0600",
            "fax_number": "636-530-3004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIERBERGS MARKETS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-12",
        "last_updated": "2009-01-30",
        "status": "A",
        "authorized_official_last_name": "GUENTHER",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_title_or_position": "DIRECTOR OF PHARMACY",
        "authorized_official_telephone_number": "636-812-1470"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "MO",
            "license": "2006004872",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "606247807",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "2636504",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DIERBERGS LAFAYETTE PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jenn Delf, MPT
• Tiffany Monique Delutis, DPM
• Luann Carmody Denten, LPC
• Laura G Denunzio, MD
• Rachel Anne Dickerson, M.D.
• Lisa S Dierdorf, LPC
• Jordan Dietl, OT
• Sandra Diver, LCSW
• Katherine G Dodge, DPT
• Robbin R Doermer, D.C.

• Community/Retail Pharmacy in Ballwin, MO
• Providers in Ballwin, MO by specialty
• Community/Retail Pharmacy in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2009; 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.