Healthcare Provider Details

I. General information

NPI: 1174111306
Provider Name (Legal Business Name): LAUREN REKOWSKI PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/04/2021
Last Update Date: 10/28/2024
Certification Date: 10/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

505 SALT LICK RD
SAINT PETERS MO
63376-1288
US

IV. Provider business mailing address

1301 S 5TH ST
SAINT CHARLES MO
63301-2457
US

V. Phone/Fax

Practice location:
  • Phone: 636-278-6561
  • Fax: 636-278-4754
Mailing address:
  • Phone: 636-946-6210
  • Fax: 636-946-9273

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number2020007468
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: