Rehoboth Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

200700836 Issued in MO

Legal business name

REHOBOTH PHARMACY LLC

Doing business as

Rehoboth Pharmacy

Practice address

9944 W Florissant Ave
Saint Louis, MO 63136-1432

Phone

(314) 868-3333

Fax

(314) 867-2330

NPI assigned

Feb 15, 2007

Organization subpart

No

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

Authorized official

Name

Idowu Ajibola

Title

Pic

Phone

(314) 249-3176

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• REHOBOTH PHARMACY Doing business as

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

{
    "created_epoch": "1171497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1282262400000",
    "number": "1700929866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9944 W FLORISSANT AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631361432",
            "telephone_number": "314-868-3333",
            "fax_number": "314-867-2330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9944 W FLORISSANT AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631361432",
            "telephone_number": "314-868-3333",
            "fax_number": "314-867-2330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REHOBOTH PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-15",
        "last_updated": "2010-08-20",
        "status": "A",
        "authorized_official_last_name": "AJIBOLA",
        "authorized_official_first_name": "IDOWU",
        "authorized_official_title_or_position": "PIC",
        "authorized_official_telephone_number": "314-249-3176"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MO",
            "license": "200700836",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "2637354",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "606309003",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "REHOBOTH PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Charles H. Rehm, M.D.
• James W. Rehm, DMD
• Ahmid Rehmani
• Michael Rehme Jr., DDS
• Michael G Rehme, D.D.S.
• Kathleen R Rehrer, AU.D.
• Andrea N Reich, PNP
• Patrick Joseph Reich, MD
• Rita Marie Reichert, COTA
• Timothy J Reichert, MD

• Community/Retail Pharmacy in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Community/Retail Pharmacy in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2010; 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.