Healthcare Provider Details

I. General information

NPI: 1245074251
Provider Name (Legal Business Name): EDNA BESIC PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2024
Last Update Date: 06/24/2024
Certification Date: 06/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5519 OAKVILLE SHOPPING CTR
SAINT LOUIS MO
63129-3554
US

IV. Provider business mailing address

5508 OAKVILLE HEIGHTS CT
SAINT LOUIS MO
63129-2983
US

V. Phone/Fax

Practice location:
  • Phone: 314-892-2840
  • Fax:
Mailing address:
  • Phone: 314-732-8845
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number2023018871
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: