NPIMap

Organization Active NPI

St Lukes Episcopal Presbyterian Hospital

Doing business as St Lukes Pharmacy Winghaven

  • Community/Retail Pharmacy
  • O'Fallon, MO
National Provider Identifier
1619968096
Registry record updated Oct 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
2008006746 Issued in MO
Legal business name
ST LUKES EPISCOPAL PRESBYTERIAN HOSPITAL
Doing business as
St Lukes Pharmacy Winghaven
Practice address
5551 Winghaven Blvd
Ste 120
O Fallon, MO 63368-3617
Phone
(636) 695-2555
Fax
(636) 695-2556
NPI assigned
Nov 3, 2005
Last updated
Oct 12, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2015

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

Authorized official

Name
Richard FookNPI 1356567168
Title
Dir of Phcy Serv
Phone
(314) 205-6291

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 2008006746 MO Primary

Addresses

Primary practice location

5551 Winghaven Blvd
Ste 120
O Fallon, MO 63368-3617

Mailing address

5551 Winghaven Blvd
Ste 120
O Fallon, MO 63368-3617
Phone (636) 695-2555

Other names 1

  • ST LUKES PHARMACY WINGHAVEN Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Daniel B Bauwens MD11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

Organizations that report the same tax identification number in the National Provider Directory.

Locations

5551 Winghaven Blvd
Ste 120
O Fallon, MO 63368
Phone (636) 695-2555

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1130976000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444608000000",
    "number": "1619968096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5551 WINGHAVEN BLVD",
            "address_2": "STE 120",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633683617",
            "telephone_number": "636-695-2555",
            "fax_number": "636-695-2556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5551 WINGHAVEN BLVD",
            "address_2": "STE 120",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633683617",
            "telephone_number": "636-695-2555",
            "fax_number": "636-695-2556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST LUKES EPISCOPAL PRESBYTERIAN HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-03",
        "last_updated": "2015-10-12",
        "status": "A",
        "authorized_official_last_name": "FOOK",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "DIR OF PHCY SERV",
        "authorized_official_telephone_number": "314-205-6291"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MO",
            "license": "2008006746",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ST LUKES PHARMACY WINGHAVEN",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in O'Fallon, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.