Healthcare Provider Details

I. General information

NPI: 1346726395
Provider Name (Legal Business Name): KATHLEEN POESCHL PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2018
Last Update Date: 07/12/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5519 OAKVILLE SHOPPING CTR
SAINT LOUIS MO
63129-3554
US

IV. Provider business mailing address

5519 OAKVILLE SHOPPING CTR
SAINT LOUIS MO
63129-3554
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number2012025443
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: