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NPI Code Detail

MEDICARE: MRS. ANGELA MARIE QUINN PHARM. D

MEDICARE: MRS. ANGELA MARIE QUINN PHARM. D
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
1183500000XPharmacist2008020950MO

General Provider Information

NPI Number : 1073893533
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ANGELA MARIE QUINN PHARM. D
Provider Business Mailing Address
First Line : 530 MID RIVERS MALL DR
Second Line :
City : SAINT PETERS
State : MO
Zip : 63376-2150
Country : US
Telephone Number : 636-970-3222
Fax Number : 636-397-5536
Provider Business Practice Location Address
First Line : 530 MID RIVERS MALL DR
Second Line :
City : SAINT PETERS
State : MO
Zip : 63376-2150
Country : US
Telephone Number : 636-970-3222
Fax Number : 636-397-5536
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/27/2011
Last Update Date : 12/21/2020

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