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NPI Code Detail

MEDICARE: AISSA CATHERINE ACELAM PHARM.D

MEDICARE: AISSA CATHERINE ACELAM 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
1183500000XPharmacist2020033883MO

General Provider Information

NPI Number : 1598369233
Entity Type Code : Individual
Provider Name (Legal Business Name) : AISSA CATHERINE ACELAM PHARM.D
Provider Business Mailing Address
First Line : 11253 SAINT CHARLES ROCK RD
Second Line :
City : BRIDGETON
State : MO
Zip : 63044-2702
Country : US
Telephone Number : 314-738-0235
Fax Number :
Provider Business Practice Location Address
First Line : 11253 SAINT CHARLES ROCK RD
Second Line :
City : BRIDGETON
State : MO
Zip : 63044-2702
Country : US
Telephone Number : 314-738-0235
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/23/2020
Last Update Date : 11/23/2020

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Directions to “ AISSA CATHERINE ACELAM PHARM.D” Practice Location

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