Healthcare Provider Details

I. General information

NPI: 1346162864
Provider Name (Legal Business Name): ZACHARY THOMAS BRASEL PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10248 BIG BEND RD
SAINT LOUIS MO
63122-6426
US

IV. Provider business mailing address

2200 LASALLE ST APT 203
SAINT LOUIS MO
63104-2766
US

V. Phone/Fax

Practice location:
  • Phone: 314-965-7076
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number051.309018
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number2026034224
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: