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Provider Information for 1235245143


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MISSOURI BAPTIST MED CNTR FMLY CRE PHRMCY SUNSET HILLS

Other Names:  
Doing Business As: 
FAMILY CARE PHARMACY SSH

Organization Subpart: NO

NPI: 1235245143
Last Updated: 2008-02-15
Certification Date:

Details

NameValue
NPI1235245143
Enumeration Date2006-08-22
NPI TypeNPI-2 Organization
StatusActive
Authorized Official Information Name: Mrs. KAREN S GUENTHER RPh
Title: Pharmacy Supervisor
Phone: 3145250415
Mailing Address 3844 S LINDBERGH BLVD
SAINT LOUIS, MO 63127-1368
United States

Phone: 314-525-0415 | Fax:
 
Primary Practice Address 3844 S LINDBERGH BLVD
SAINT LOUIS, MO 63127-1368
United States

Phone: 314-525-0415 | Fax:314-525-0401
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
Other (non-Medicare)2619166Other ID Number-Commercial Number
Other (non-Medicare)2619166Other ID Number
MEDICAIDMO608873501
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
No 333600000X - Pharmacy
Yes 3336C0003X - Pharmacy - Community/Retail PharmacyMO2003002133