Healthcare Provider Details

I. General information

NPI: 1760109136
Provider Name (Legal Business Name): RACHEL MARIE HAUG PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/25/2022
Last Update Date: 10/25/2022
Certification Date: 10/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12332 MANCHESTER RD
SAINT LOUIS MO
63131-4315
US

IV. Provider business mailing address

6143 REGINA RD
CEDAR HILL MO
63016-3615
US

V. Phone/Fax

Practice location:
  • Phone: 314-965-0062
  • Fax:
Mailing address:
  • Phone: 636-575-1435
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number2022041314
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: