Healthcare Provider Details

I. General information

NPI: 1518920354
Provider Name (Legal Business Name): CARON C BEDELL PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 04/11/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

915 N GRAND BLVD
SAINT LOUIS MO
63106-1621
US

IV. Provider business mailing address

3003 CAMBRIDGE POINTE DR
SAINT LOUIS MO
63129-6613
US

V. Phone/Fax

Practice location:
  • Phone: 314-289-6439
  • Fax:
Mailing address:
  • Phone: 314-846-9617
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: