Healthcare Provider Details

I. General information

NPI: 1801341292
Provider Name (Legal Business Name): CAR PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/16/2016
Last Update Date: 02/21/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5378 SOUTHWEST AVE
SAINT LOUIS MO
63139-1446
US

IV. Provider business mailing address

5378 SOUTHWEST AVE
SAINT LOUIS MO
63139-1446
US

V. Phone/Fax

Practice location:
  • Phone: 314-776-9460
  • Fax: 314-776-9463
Mailing address:
  • Phone: 314-776-9460
  • Fax: 314-776-9463

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number2016029709
License Number StateMO
# 3
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: CHRISTOPHER REYNHOUT
Title or Position: OWNER/PIC/AO
Credential: PHARM.D.
Phone: 314-393-6263