Dellwood Pharmacy LLC
Pharmacy, Community/Retail Pharmacy in Saint Louis, MO. Organization (NPI-2).
NPI number1194356667
StatusActive
Last updated in NPPESMar 28, 2022
Details
- NPI
- 1194356667
- Entity type
- Organization (NPI-2)
- Legal business name
- Dellwood Pharmacy LLC
- Organization subpart
- No
- Enumeration date
- Feb 3, 2020
- Certification date
- Mar 28, 2022
- Last updated
- Mar 28, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 3336C0003X | Pharmacy, Community/Retail Pharmacy | – | – | Yes |
| 291U00000X | Clinical Medical Laboratory | – | – |
Practice location
9944 W Florissant AveSaint Louis, MO 63136-1432
Phone 314-868-3333
Mailing address
9944 W Florissant AveSaint Louis, MO 63136-1432
Phone 314-868-3333 · Fax 314-867-2330
Authorized official
Rebecca Mawuenyega
Owner/Manager
3146072603
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