Healthcare Provider Details

I. General information

NPI: 1356278261
Provider Name (Legal Business Name): ERIN MARIE HANLON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2026
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6420 CLAYTON RD FL 1
SAINT LOUIS MO
63117-1811
US

IV. Provider business mailing address

9751 LILAC DR
SAINT LOUIS MO
63137-3333
US

V. Phone/Fax

Practice location:
  • Phone: 314-768-8397
  • Fax: 314-768-7154
Mailing address:
  • Phone: 314-768-8397
  • Fax: 314-768-7154

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License Number2010020819
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: