Healthcare Provider Details

I. General information

NPI: 1003281619
Provider Name (Legal Business Name): WASHINGTON UNIVERSITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/08/2015
Last Update Date: 04/11/2025
Certification Date: 04/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 ENTRANCE WAY
SAINT PETERS MO
63376-1645
US

IV. Provider business mailing address

PO BOX 7412011
CHICAGO IL
60674-2011
US

V. Phone/Fax

Practice location:
  • Phone: 636-916-9847
  • Fax: 636-916-9079
Mailing address:
  • Phone: 636-916-9847
  • Fax: 636-916-9079

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number2015041512
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number2015041512
License Number StateMO

VIII. Authorized Official

Name: MS. CATHY EGHIGIAN
Title or Position: SR DIRECTOR MANAGED CARE
Credential:
Phone: 314-273-0770