Healthcare Provider Details

I. General information

NPI: 1649751744
Provider Name (Legal Business Name): LSCS HOLDINGS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/27/2018
Last Update Date: 08/27/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17877 CHESTERFIELD AIRPORT RD
CHESTERFIELD MO
63005-1211
US

IV. Provider business mailing address

444 W LAKE ST STE 1800
CHICAGO IL
60606-0096
US

V. Phone/Fax

Practice location:
  • Phone: 636-519-2496
  • Fax:
Mailing address:
  • Phone: 636-519-2496
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: BRIAN D DAVIS
Title or Position: VP, CONTRACTING AND PAYER ACCESS
Credential: RPH
Phone: 636-519-2496