Healthcare Provider Details

I. General information

NPI: 1154256485
Provider Name (Legal Business Name): ANGELA SZEWCZYK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2026
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7470 MANCHESTER RD
SAINT LOUIS MO
63143-3032
US

IV. Provider business mailing address

3130 MAGNOLIA AVE
SAINT LOUIS MO
63118-1372
US

V. Phone/Fax

Practice location:
  • Phone: 314-646-8037
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number071705
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number2026017913
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: