Healthcare Provider Details

I. General information

NPI: 1538442587
Provider Name (Legal Business Name): VINCENT JOSEPH LENZI PHARM D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/26/2011
Last Update Date: 09/26/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 GRASSO PLZ
AFFTON MO
63123-3107
US

IV. Provider business mailing address

3336 MACKLIND AVE
SAINT LOUIS MO
63139-1539
US

V. Phone/Fax

Practice location:
  • Phone: 314-631-8800
  • Fax:
Mailing address:
  • Phone: 217-622-8656
  • Fax: 314-544-9086

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number2006024030
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: