Healthcare Provider Details

I. General information

NPI: 1518287648
Provider Name (Legal Business Name): PHARMACY SERVICES INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2010
Last Update Date: 06/11/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

212 MILLWELL DR. SUITE A
ST. LOUIS MO
63043
US

IV. Provider business mailing address

212 MILLWELL DR. SUITE A
ST. LOUIS MO
63043
US

V. Phone/Fax

Practice location:
  • Phone: 314-956-6767
  • Fax:
Mailing address:
  • Phone: 314-956-6767
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number044866
License Number StateMO

VIII. Authorized Official

Name: RODNEY G WILSON
Title or Position: PRESIDENT
Credential: R.PH.
Phone: 314-956-6767