Healthcare Provider Details

I. General information

NPI: 1295320455
Provider Name (Legal Business Name): HEALTHDIRECT INSTITUTIONAL PHARMACY SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/09/2021
Last Update Date: 03/09/2021
Certification Date: 03/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 WESTPORT CENTER DR
SAINT LOUIS MO
63146-3564
US

IV. Provider business mailing address

1 ADLER DR
EAST SYRACUSE NY
13057-1223
US

V. Phone/Fax

Practice location:
  • Phone: 314-373-1111
  • Fax:
Mailing address:
  • Phone: 888-331-8338
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: STACEY KRUTH
Title or Position: VICE PRESIDENT OF FINANCE
Credential:
Phone: 888-331-3883