Active NPI
Ajla Dedic, PHARMD
- Pharmacist
- Saint Louis, MO
National Provider Identifier
1821574799
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 2013027424
- Practice address
- 10070 Gravois Rd
Saint Louis, MO 63123-4024 - Phone
- (314) 631-6781
- Fax
- (314) 631-6782
- NPI assigned
- Jul 13, 2018
- Last updated
- Jul 13, 2018
- Sex
- Female
- Sole proprietor
- Yes
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 | 2013027424 | MO | Primary |
Addresses
Primary practice location
10070 Gravois Rd
Saint Louis, MO 63123-4024
Mailing address
10070 Gravois Rd
Saint Louis, MO 63123-4024
Phone (314) 631-6781
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
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2013027424 | MO | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1531440000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1531440000000",
"number": "1821574799",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10070 GRAVOIS RD",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631234024",
"telephone_number": "314-631-6781",
"fax_number": "314-631-6782"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10070 GRAVOIS RD",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631234024",
"telephone_number": "314-631-6781",
"fax_number": "314-631-6782"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEDIC",
"first_name": "AJLA",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-07-13",
"last_updated": "2018-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MO",
"license": "2013027424",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Louis, MO
- William Declue
- David Decresce, MD
- Dana Marie Decuffa, MD
- Matthew R Decuffa, M.D.
- Andrea Janae Decuir, LPN
- Dedicated Hearts Home Care Services, LLC
- Dedicated Missouri Holding, LLC (Dedicated Senior Medical Center Tower Grove)
- Dedicated Missouri Holding, LLC (Dedicated Senior Medical Center Ferguson)
- Dedicated Missouri Holding, LLC (Dedicated Senior Medical Center Page Boulevard)
- Dedicated Missouri Holding, LLC (Dedicated Senior Medical Center North St. Louis)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.