Organization Active NPI

West County Pharmacy LLC

  • Community/Retail Pharmacy
  • Des Peres, MO
National Provider Identifier
1730638958
Registry record updated Dec 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
2016032997 Issued in MO
Legal business name
WEST COUNTY PHARMACY LLC
Practice address
13354 Manchester Rd Ste 101
Des Peres, MO 63131-1738
Phone
(314) 432-5020
Fax
(314) 432-5026
NPI assigned
Sep 29, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2022

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

Authorized official

Name
Donald Schreiber
Title
President
Phone
(314) 965-4700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 2016032997 MO Primary

Addresses

Primary practice location

13354 Manchester Rd Ste 101
Des Peres, MO 63131-1738

Mailing address

777 S New Ballas Rd
Saint Louis, MO 63141-8705
Phone (314) 432-5020

Other identifiers 1

IdentifierTypeStateIssuer
2164196OtherPK

Other names 1

  • Goldsmith Medicenter Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20161017001450 MO Part B Supplier - Mass Immunization (Roster Biller Only) 2860780350 Practice locations: Des Peres, MO
O20210513001747 MO Part B Supplier - Pharmacy 2860780350 Practice locations: Des Peres, MO
O20210602002011 MO Part B Supplier - Independent Clinical Laboratory 2860780350 Practice locations: Des Peres, MO

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
26D2187890Goldsmith Medicenter Pharmacy13354 Manchester Road Suite 101, Des Peres, MO 63131Certificate of waiverJul 8, 2028

National Provider Directory

National Provider Directory

Locations

777 S New Ballas Rd
Lbby 1
Saint Louis, MO 63141
Phone (314) 432-6020

13354 Manchester Rd
Ste 101
Saint Louis, MO 63131
Phone (314) 432-5020

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1475107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670198400000",
    "number": "1730638958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 S NEW BALLAS RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418705",
            "telephone_number": "314-432-5020",
            "fax_number": "314-432-5026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13354 MANCHESTER RD STE 101",
            "city": "DES PERES",
            "state": "MO",
            "postal_code": "631311738",
            "telephone_number": "314-432-5020",
            "fax_number": "314-432-5026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST COUNTY PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-29",
        "last_updated": "2022-12-05",
        "certification_date": "2022-12-05",
        "status": "A",
        "authorized_official_last_name": "SCHREIBER",
        "authorized_official_first_name": "DONALD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "314-965-4700"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MO",
            "license": "2016032997",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2164196",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Goldsmith Medicenter Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Goldsmith Medicenter Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Des Peres, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.