Healthcare Provider Details

I. General information

NPI: 1497097885
Provider Name (Legal Business Name): JOHN T CALLAHAN R.PH.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/23/2013
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 JEFFERSON BARRACKS DR
SAINT LOUIS MO
63125-4181
US

IV. Provider business mailing address

901 WASHINGTON AVE UNIT 504
SAINT LOUIS MO
63101-1259
US

V. Phone/Fax

Practice location:
  • Phone: 314-894-6570
  • Fax: 314-845-5091
Mailing address:
  • Phone: 719-510-8155
  • Fax: 314-845-5091

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number051303891
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number2589
License Number StateWY
# 3
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number10452
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: