Organization Active NPI

Dierbergs Markets Inc

Doing business as Dierbergs Deer Creek Crossing Pharmacy

  • Community/Retail Pharmacy
  • O'Fallon, MO
National Provider Identifier
1629167390
Registry record updated Jan 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
DIERBERGS MARKETS INC
Doing business as
Dierbergs Deer Creek Crossing Pharmacy
Practice address
2979 Highway K
O Fallon, MO 63368-7862
Phone
(636) 379-8910
Fax
(636) 530-3017
NPI assigned
Oct 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2009

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

Authorized official

Name
Gregory Guenther
Title
Director of Pharmacy
Phone
(636) 812-1470

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X 006651 MO
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

2979 Highway K
O Fallon, MO 63368-7862

Mailing address

PO Box 1070
Chesterfield, MO 63006-1070
Phone (636) 812-1470

Other identifiers 2

IdentifierTypeStateIssuer
2632784OtherOTHER ID NUMBER-COMMERCIAL NUMBER
605711605MedicaidMO

Other names 1

  • DIERBERGS DEER CREEK CROSSING PHARMACY Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1233273600000",
    "number": "1629167390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1070",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630061070",
            "telephone_number": "636-812-1470",
            "fax_number": "636-812-1603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2979 HIGHWAY K",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633687862",
            "telephone_number": "636-379-8910",
            "fax_number": "636-530-3017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIERBERGS MARKETS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-12",
        "last_updated": "2009-01-30",
        "status": "A",
        "authorized_official_last_name": "GUENTHER",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_title_or_position": "DIRECTOR OF PHARMACY",
        "authorized_official_telephone_number": "636-812-1470"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "MO",
            "license": "006651",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "2632784",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "605711605",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DIERBERGS DEER CREEK CROSSING PHARMACY",
            "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 Jan 30, 2009; 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.