SSM Pharmacy @ Depaul
Organization Active NPI Pharmacist · Bridgeton, MO
NPI 1699861674 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1699861674
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Pharmacist 183500000X
- License
- 42638 (MO)
- Legal business name
- SSM PHARMACY @ DEPAUL
- Practice address
- 12255 De Paul Dr Ste 120
Bridgeton, MO 63044-2513 - Phone
- (314) 344-7300
- Fax
- (314) 344-6179
- NPI assigned
- Oct 5, 2006
- Organization subpart
- No
Authorized official
- Name
- Mr. Bradley Arens, RPH
- Title
- Manger/Pic
- Phone
- (314) 344-7300
Corporate family (same tax ID) 2
National Provider Directory
- Tax ID family
- SSM Depaul Health Center
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist |
183500000X | 42638 | MO | Yes |
Addresses
Primary practice location
12255 De Paul Dr Ste 120
Bridgeton, MO 63044-2513
Mailing address
12255 De Paul Dr Ste 120
Bridgeton, MO 63044-2513
Phone (314) 344-7300
Other providers in Bridgeton, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. 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.