Healthcare Provider Details

I. General information

NPI: 1811358138
Provider Name (Legal Business Name): OPTIME CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/14/2016
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4060 WEDGEWAY CT
EARTH CITY MO
63045-1213
US

IV. Provider business mailing address

4060 WEDGEWAY CT
EARTH CITY MO
63045-1213
US

V. Phone/Fax

Practice location:
  • Phone: 314-731-6900
  • Fax: 888-868-3147
Mailing address:
  • Phone: 314-731-6900
  • Fax: 888-868-3147

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: SERGIO BARRANCO-MEDINA
Title or Position: PHARMACIST-IN-CHARGE
Credential:
Phone: 314-731-6900