Michael Bopp
Individual provider Active NPI Pharmacist · Maplewood, MO
NPI 1366043853 · NPPES record last updated Nov 3, 2020
Key facts
- NPI
- 1366043853
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 2009023425 (MO)
- Practice address
- 1900 Maplewood Commons Dr
Pharmacy
Maplewood, MO 63143 - Phone
- (314) 781-2935
- NPI assigned
- Nov 3, 2020
- Sex
- Male
- 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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2009023425 | MO | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 2009023425 | MO | Yes |
Addresses
Primary practice location
1900 Maplewood Commons Dr
Pharmacy
Maplewood, MO 63143
Mailing address
1900 Maplewood Commons Dr
Pharmacy
Maplewood, MO 63143
Other providers in Maplewood, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 3, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.