Brett Rough, RPH
Individual provider Active NPI Pharmacist · Ofallon, MO
NPI 1942585997 · NPPES record last updated Oct 20, 2011
Key facts
- NPI
- 1942585997
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 041269 (MO)
- Practice address
- 2920 Hwy K
Ofallon, MO 63368 - Phone
- (636) 240-5077
- NPI assigned
- Oct 20, 2011
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 041269 | MO | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 041269 | MO | Yes |
Addresses
Primary practice location
2920 Hwy K
Ofallon, MO 63368
Mailing address
4 Steepleview CT
Ofallon, MO 63366
Phone (636) 439-0227
Other providers in Ofallon, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 20, 2011. 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.