Healthcare Provider Details

I. General information

NPI: 1124849179
Provider Name (Legal Business Name): ARMON MEISSAMI VAKIL PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/22/2024
Last Update Date: 10/22/2024
Certification Date: 10/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 JUNGERMANN RD
SAINT PETERS MO
63376-5347
US

IV. Provider business mailing address

18 MARCUS DR
SAINT PETERS MO
63376-7484
US

V. Phone/Fax

Practice location:
  • Phone: 636-922-9019
  • Fax:
Mailing address:
  • Phone: 636-387-2638
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number2024033718
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: