Healthcare Provider Details

I. General information

NPI: 1720539752
Provider Name (Legal Business Name): EXPRESS MEDICAL PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/14/2016
Last Update Date: 09/19/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 ROYAL HEIGHTS CTR
BELLEVILLE IL
62226-5705
US

IV. Provider business mailing address

1010 DEVONWORTH MANOR WAY
TOWN AND COUNTRY MO
63017-8548
US

V. Phone/Fax

Practice location:
  • Phone: 800-633-4227
  • Fax: 618-641-9801
Mailing address:
  • Phone: 618-973-3879
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number2018005586
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336M0002X
TaxonomyMail Order Pharmacy
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number054019416
License Number StateIL

VIII. Authorized Official

Name: HIBA ALHALABI
Title or Position: OWNER PHARMACIST IN CHARGE
Credential:
Phone: 618-973-3879