MEDICARE: GEORGE KATSIYIANNIS

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
1	183500000X	Pharmacist	043563	MO

General Provider Information

NPI Number	:	1407798697
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GEORGE KATSIYIANNIS

Provider Business Mailing Address
First Line	:	4525 LACLEDE AVE APT 14
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63108-2116
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3171 RIVERPORT TECH CENTER DR
Second Line	:
City	:	MARYLAND HEIGHTS
State	:	MO
Zip	:	63043-4825
Country	:	US
Telephone Number	:	314-627-6135
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/07/2026
Last Update Date	:	04/07/2026

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Directions to “ GEORGE KATSIYIANNIS ” Practice Location

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