Jason Baechle, PHARMD
Individual provider Active NPI Pharmacist · O Fallon, MO
NPI 1598048738 · NPPES record last updated Dec 16, 2019
Key facts
- NPI
- 1598048738
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 2009020979 (MO)
- Practice address
- 7422 Highway N
O Fallon, MO 63368-7013 - Phone
- (636) 625-5012
- Fax
- (636) 625-5015
- NPI assigned
- Sep 23, 2011
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2009020979 | MO | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past |
Accepting new patients | |
| Walgreen Co | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 2009020979 | MO | Yes |
Addresses
Primary practice location
7422 Highway N
O Fallon, MO 63368-7013
Mailing address
7422 Highway N
O Fallon, MO 63368-7013
Phone (636) 625-5012
Other providers in O Fallon, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 16, 2019. 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.