Healthcare Provider Details

I. General information

NPI: 1700709094
Provider Name (Legal Business Name): SAMANTHA JOANN SENKO PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/03/2026
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 S GRAND BLVD
SAINT LOUIS MO
63104-1016
US

IV. Provider business mailing address

19735 W ASH ST
ELWOOD IL
60421-9391
US

V. Phone/Fax

Practice location:
  • Phone: 314-257-1220
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number2026036973
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: