Healthcare Provider Details

I. General information

NPI: 1245916956
Provider Name (Legal Business Name): JOANNA M CALLIER PHARM D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2023
Last Update Date: 06/26/2023
Certification Date: 06/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6600 CLAYTON RD
SAINT LOUIS MO
63117-1602
US

IV. Provider business mailing address

6600 CLAYTON RD
SAINT LOUIS MO
63117-1602
US

V. Phone/Fax

Practice location:
  • Phone: 314-644-3580
  • Fax:
Mailing address:
  • Phone: 314-644-3580
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number2023023516
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: