Healthcare Provider Details

I. General information

NPI: 1033426424
Provider Name (Legal Business Name): ESI MAIL PHARMACY SERVICE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/07/2010
Last Update Date: 12/05/2025
Certification Date: 12/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4600 N HANLEY RD STE D
SAINT LOUIS MO
63134-2715
US

IV. Provider business mailing address

4600 N HANLEY RD STE D
SAINT LOUIS MO
63134-2715
US

V. Phone/Fax

Practice location:
  • Phone: 800-451-6245
  • Fax: 800-521-5779
Mailing address:
  • Phone: 800-451-6245
  • Fax: 800-521-5779

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336M0002X
TaxonomyMail Order Pharmacy
License Number2010008501
License Number StateMO

VIII. Authorized Official

Name: SUSAN PEPPERS
Title or Position: ASSISTANT SECRETARY
Credential:
Phone: 513-858-4916