Individual provider Active NPI

Roselyn Tamunday Santos, RPH

  • Pharmacist
  • Saint Louis, MO
National Provider Identifier
1790024677
Registry record updated Feb 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
2002027581 Issued in MO
Practice address
4473 Forest Park Ave
Saint Louis, MO 63108-2211
Phone
(314) 381-1818
Fax
(314) 667-3202
NPI assigned
Feb 12, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 12, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 2002027581 MO Primary

Addresses

Primary practice location

4473 Forest Park Ave
Saint Louis, MO 63108-2211

Mailing address

15936 Eagles Landing CT
Chesterfield, MO 63017-7383
Phone (314) 498-5855

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
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
2002027581MOMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Gateway Apothecary 3960, LLC PastSince Feb 27, 2022 Accepting new patients
Gateway Apothecary 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": "1360627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360627200000",
    "number": "1790024677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15936 EAGLES LANDING CT",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630177383",
            "telephone_number": "314-498-5855",
            "fax_number": "314-371-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4473 FOREST PARK AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631082211",
            "telephone_number": "314-381-1818",
            "fax_number": "314-667-3202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTOS",
        "first_name": "ROSELYN",
        "middle_name": "TAMUNDAY",
        "name_prefix": "Mrs.",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-02-12",
        "last_updated": "2013-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MO",
            "license": "2002027581",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2013; 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.