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NPI Code Detail

MEDICARE: DR. MARIA GORLA PHARMD

MEDICARE: DR. MARIA GORLA PHARMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist2021026544MO

General Provider Information

NPI Number : 1063185841
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARIA GORLA PHARMD
Provider Business Mailing Address
First Line : 5626 WILSON AVE
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63110-2706
Country : US
Telephone Number : 314-954-1297
Fax Number :
Provider Business Practice Location Address
First Line : 915 N GRAND BLVD
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63106-1621
Country : US
Telephone Number : 314-652-4100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/28/2021
Last Update Date : 04/07/2026

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Directions to “ DR. MARIA GORLA PHARMD” Practice Location

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