Healthcare Provider Details

I. General information

NPI: 1861331845
Provider Name (Legal Business Name): CHANEL ANITA TURNER PHARM TECH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/26/2026
Last Update Date: 03/28/2026
Certification Date: 03/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2315 S KINGSHIGHWAY BLVD
SAINT LOUIS MO
63110-3419
US

IV. Provider business mailing address

3155 SUMMERFIELD LN APT 100
FLORISSANT MO
63033-1639
US

V. Phone/Fax

Practice location:
  • Phone: 314-773-2767
  • Fax:
Mailing address:
  • Phone: 314-773-2767
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License Number2024016997
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: