NPIMap

Organization Active NPI

Express Scripts Specialty Distribution Services, Inc.

Doing business as Express Scripts Specialty Dist SVCS

  • Pharmacy
  • Saint Louis, MO
National Provider Identifier
1467534826
Registry record updated May 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
2000168119 Issued in MO
Legal business name
EXPRESS SCRIPTS SPECIALTY DISTRIBUTION SERVICES, INC.
Doing business as
Express Scripts Specialty Dist SVCS
Practice address
4600 N Hanley Rd Ste B
Saint Louis, MO 63134-2715
Phone
(800) 332-5455
Fax
(877) 304-9042
NPI assigned
Oct 19, 2006
Last updated
May 10, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 10, 2023

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

Authorized official

Name
Susan Peppers
Title
Assistant Secretary
Phone
(513) 858-4916

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X 2000168119 MO Primary
Community/Retail Pharmacy 3336C0003X

Addresses

Primary practice location

4600 N Hanley Rd Ste B
Saint Louis, MO 63134-2715

Mailing address

21162 Network PL
Chicago, IL 60673-1238
Phone (800) 332-5455

Other names 1

  • EXPRESS SCRIPTS SPECIALTY DIST SVCS Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180220003009 MO Part B Supplier - Pharmacy 3678684164 Practice locations: Saint Louis, MO

National Provider Directory

National Provider Directory

Locations

21162 Network Pl
Chicago, IL 60673

3168 Riverport Tech Center Dr
Maryland Heights, MO 63043
Phone (314) 702-7445

Practitioners & affiliated clinicians

Practitioners 20

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.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683676800000",
    "number": "1467534826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21162 NETWORK PL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606731238",
            "telephone_number": "800-332-5455",
            "fax_number": "877-304-9042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4600 N HANLEY RD STE B",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631342715",
            "telephone_number": "800-332-5455",
            "fax_number": "877-304-9042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXPRESS SCRIPTS SPECIALTY DISTRIBUTION SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-19",
        "last_updated": "2023-05-10",
        "certification_date": "2023-05-10",
        "status": "A",
        "authorized_official_last_name": "PEPPERS",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "ASSISTANT SECRETARY",
        "authorized_official_telephone_number": "513-858-4916"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "MO",
            "license": "2000168119",
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "EXPRESS SCRIPTS SPECIALTY DIST SVCS",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "EXPRESS SCRIPTS SPECIALTY DIST SVCS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2023; 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.