Healthcare Provider Details

I. General information

NPI: 1265353833
Provider Name (Legal Business Name): CALEB AARON BASS CPHT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2026
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3900 VOGEL RD
ARNOLD MO
63010-6204
US

IV. Provider business mailing address

1299 ROCKWOOD FOREST DR
ARNOLD MO
63010-4323
US

V. Phone/Fax

Practice location:
  • Phone: 636-282-7555
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License Number2025015588
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: