Healthcare Provider Details

I. General information

NPI: 1043758113
Provider Name (Legal Business Name): SHARLENE POWERS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/08/2017
Last Update Date: 01/05/2026
Certification Date: 01/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2315 TECHNOLOGY DR STE 113
O FALLON MO
63368-7371
US

IV. Provider business mailing address

1709 DAVINCI DR
O FALLON MO
63368-6836
US

V. Phone/Fax

Practice location:
  • Phone: 636-265-2924
  • Fax: 636-265-1306
Mailing address:
  • Phone: 636-699-8082
  • Fax: 636-265-1306

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number043673
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: