Healthcare Provider Details

I. General information

NPI: 1891380390
Provider Name (Legal Business Name): CHRISTOPHER GEORGE STREISEL PHARM.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/05/2021
Last Update Date: 03/05/2021
Certification Date: 02/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

ONE CHILDREN'S PLACE PHARMACY DEPT.
ST. LOUIS MO
63110
US

IV. Provider business mailing address

2336 CASTLEGATE DR
IMPERIAL MO
63052-3814
US

V. Phone/Fax

Practice location:
  • Phone: 314-454-2618
  • Fax:
Mailing address:
  • Phone: 636-399-4052
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number2019042074
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: