NPIMap

Organization Active NPI

Alexian Brothers Comm SVCS Pharmacy

Doing business as Alexian Brothers Community Services Pharmacy

  • Community/Retail Pharmacy
  • Saint Louis, MO
National Provider Identifier
1912216441
Registry record updated Oct 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
006607 Issued in MO
Legal business name
ALEXIAN BROTHERS COMM SVCS PHARMACY
Doing business as
Alexian Brothers Community Services Pharmacy
Practice address
3900 S Grand Blvd
Saint Louis, MO 63118-3414
Phone
(314) 771-5800
Fax
(314) 771-6819
NPI assigned
Oct 1, 2010
Last updated
Oct 1, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2010

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

Authorized official

Name
Alfreda Pulley
Title
Pharmacy Director
Phone
(314) 771-5800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 006607 MO Primary

Addresses

Primary practice location

3900 S Grand Blvd
Saint Louis, MO 63118-3414

Mailing address

3900 S Grand Blvd
Saint Louis, MO 63118-3414
Phone (314) 771-5800

Other identifiers 2

IdentifierTypeStateIssuer
2633154OtherNCPDP PROVIDER IDENTIFICATION NUMBER
894768001MedicaidMO

Other names 1

  • ALEXIAN BROTHERS COMMUNITY SERVICES PHARMACY Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Alexian Brothers Pace6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1285891200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1285891200000",
    "number": "1912216441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3900 S GRAND BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631183414",
            "telephone_number": "314-771-5800",
            "fax_number": "314-771-6819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 S GRAND BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631183414",
            "telephone_number": "314-771-5800",
            "fax_number": "314-771-6819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALEXIAN BROTHERS COMM SVCS PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-01",
        "last_updated": "2010-10-01",
        "status": "A",
        "authorized_official_last_name": "PULLEY",
        "authorized_official_first_name": "ALFREDA",
        "authorized_official_title_or_position": "PHARMACY DIRECTOR",
        "authorized_official_telephone_number": "314-771-5800"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MO",
            "license": "006607",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "2633154",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "894768001",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ALEXIAN BROTHERS COMMUNITY SERVICES PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Oct 1, 2010; 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.