Active NPI
Denise Haller
- Pharmacist
- Ballwin, MO
National Provider Identifier
1720362023
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 043606
- Practice address
- 1205 Sulphur Spring Rd
Ballwin, MO 63021-7497 - Phone
- (636) 230-7367
- NPI assigned
- Oct 5, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 043606 | MO | Primary |
Addresses
Primary practice location
1205 Sulphur Spring Rd
Ballwin, MO 63021-7497
Mailing address
2800 Winter Way
Eureka, MO 63025-3575
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 043606 | MO | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1317772800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1317772800000",
"number": "1720362023",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2800 WINTER WAY",
"city": "EUREKA",
"state": "MO",
"postal_code": "630253575"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1205 SULPHUR SPRING RD",
"city": "BALLWIN",
"state": "MO",
"postal_code": "630217497",
"telephone_number": "636-230-7367"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HALLER",
"first_name": "DENISE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-10-05",
"last_updated": "2011-10-05",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MO",
"license": "043606",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ballwin, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.