Menatalla Abdellatif
Individual provider Active NPI Pharmacist · Saint Louis, MO
NPI 1912749458 · NPPES record last updated Jun 6, 2024
Key facts
- NPI
- 1912749458
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 2020035092 (MO)
- Practice address
- 10007 Kennerly Rd Ste a
Saint Louis, MO 63128-2179 - Phone
- (314) 270-9070
- NPI assigned
- Jun 6, 2024
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2020035092 | MO | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 2020035092 | MO | Yes |
Addresses
Primary practice location
10007 Kennerly Rd Ste a
Saint Louis, MO 63128-2179
Mailing address
417 Gatehall LN
Ballwin, MO 63011-2718
Phone (573) 772-2190
Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 6, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.