Healthcare Provider Details

I. General information

NPI: 1902578644
Provider Name (Legal Business Name): UZENDU RX
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/01/2021
Last Update Date: 10/01/2021
Certification Date: 10/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1551 WALL ST STE 110
SAINT CHARLES MO
63303-3540
US

IV. Provider business mailing address

1551 WALL ST STE 110
SAINT CHARLES MO
63303-3540
US

V. Phone/Fax

Practice location:
  • Phone: 636-493-9008
  • Fax: 636-493-9008
Mailing address:
  • Phone: 636-493-9008
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: DR. GOZIE EZEKWU UZENDU
Title or Position: PHARMACIST-IN-CHARGE
Credential: PHARMD, MBA
Phone: 314-489-8582