Healthcare Provider Details

I. General information

NPI: 1881507689
Provider Name (Legal Business Name): STEPHEN MOERLEIN PHARMD, PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/24/2026
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4525 SCOTT AVE
SAINT LOUIS MO
63110-1030
US

IV. Provider business mailing address

4525 SCOTT AVE
SAINT LOUIS MO
63110-1030
US

V. Phone/Fax

Practice location:
  • Phone: 314-362-8466
  • Fax: 314-747-5999
Mailing address:
  • Phone: 314-362-8466
  • Fax: 314-747-5999

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1835N0905X
TaxonomyNuclear Pharmacist
License Number029638
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number029638
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: