Healthcare Provider Details

I. General information

NPI: 1427160423
Provider Name (Legal Business Name): ALAN C HONERKAMP INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

488 S 5TH ST
SAINT CHARLES MO
63301-2633
US

IV. Provider business mailing address

488 S 5TH ST
SAINT CHARLES MO
63301-2633
US

V. Phone/Fax

Practice location:
  • Phone: 636-949-5593
  • Fax: 636-949-3118
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number004195
License Number StateMO
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: ALAN HONERKAMP
Title or Position: OWNER PHARMACIST
Credential: RPH
Phone: 636-949-5593