NPIMap

Organization Active NPI

Crescent United LLC

Doing business as DirectRx Pharmacy

  • Community/Retail Pharmacy
  • Manchester, MO
National Provider Identifier
1841691771
Registry record updated Sep 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
2014032156 Issued in MO
Legal business name
CRESCENT UNITED LLC
Doing business as
DirectRx Pharmacy
Practice address
140 Enchanted Pkwy
Suite 100
Manchester, MO 63021-5491
Phone
(636) 675-1123
NPI assigned
Sep 10, 2014
Last updated
Sep 10, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2014

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

Authorized official

Name
Dr. Ihtesham Gohar, PHARMDNPI 1578804811
Title
Owner
Phone
(636) 675-1123

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 2014032156 MO Primary
Compounding Pharmacy 3336C0004X 2014032156 MO

Addresses

Primary practice location

140 Enchanted Pkwy
Suite 100
Manchester, MO 63021-5491

Mailing address

140 Enchanted Pkwy
Suite 100
Manchester, MO 63021-5491
Phone (636) 675-1123

Other names 1

  • DirectRx Pharmacy Doing business as

National Provider Directory

National Provider Directory

Locations

140 Enchanted Pkwy
Ste 100
Manchester, MO 63021
Phone (636) 675-1123

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1410307200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1410307200000",
    "number": "1841691771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 ENCHANTED PKWY",
            "address_2": "SUITE 100",
            "city": "MANCHESTER",
            "state": "MO",
            "postal_code": "630215491",
            "telephone_number": "636-675-1123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 ENCHANTED PKWY",
            "address_2": "SUITE 100",
            "city": "MANCHESTER",
            "state": "MO",
            "postal_code": "630215491",
            "telephone_number": "636-675-1123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRESCENT UNITED LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-10",
        "last_updated": "2014-09-10",
        "status": "A",
        "authorized_official_last_name": "GOHAR",
        "authorized_official_first_name": "IHTESHAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "636-675-1123",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MO",
            "license": "2014032156",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "MO",
            "license": "2014032156",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DirectRx Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Manchester, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2014; 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.