Molly Kathleen Larue, PHARMD

Individual provider Active NPI Pharmacist · Lake Saint Louis, MO

NPI 1215537618 · NPPES record last updated Oct 27, 2020

Key facts

NPI
1215537618
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacist 183500000X
License
2000172874 (MO)
Practice address
6100 Ronald Reagan Dr
Lake Saint Louis, MO 63367-2660
Phone
(636) 625-2137
Fax
(636) 625-2138
NPI assigned
Oct 27, 2020
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
2000172874MOMDPharmacist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 2000172874 MO Yes

Addresses

Primary practice location

6100 Ronald Reagan Dr
Lake Saint Louis, MO 63367-2660

Mailing address

28014 Pincecrest Dr
Wright City, MO 63390
Phone (314) 803-5450

Other providers in Lake Saint Louis, MO

All providers in Lake Saint Louis, MO · Pharmacist in Missouri

Sources for this page

Verify at the official NPI Registry.