Active NPI
Melvin Eugene Kottwitz, RPH
- Pharmacist
- Lake St Louis, MO
National Provider Identifier
1508342056
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 40445
- Practice address
- 101 Civic Center Dr
Lake St Louis, MO 63367-3027 - Phone
- (636) 561-3963
- Fax
- (636) 561-5317
- NPI assigned
- Jul 18, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 40445 | MO | Primary |
Addresses
Primary practice location
101 Civic Center Dr
Lake St Louis, MO 63367-3027
Mailing address
101 Civic Center Dr
Lake St Louis, MO 63367-3027
Phone (636) 561-3963
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 40445 | MO | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1531872000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1531872000000",
"number": "1508342056",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 CIVIC CENTER DR",
"city": "LAKE ST LOUIS",
"state": "MO",
"postal_code": "633673027",
"telephone_number": "636-561-3963",
"fax_number": "636-561-5317"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 CIVIC CENTER DR",
"city": "LAKE ST LOUIS",
"state": "MO",
"postal_code": "633673027",
"telephone_number": "636-561-3963",
"fax_number": "636-561-5317"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOTTWITZ",
"first_name": "MELVIN",
"middle_name": "EUGENE",
"name_prefix": "Mr.",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-07-18",
"last_updated": "2018-07-18",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MO",
"license": "40445",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lake St Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.