Healthcare Provider Details

I. General information

NPI: 1598592479
Provider Name (Legal Business Name): BRITTANY HEUAY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2024
Last Update Date: 09/16/2024
Certification Date: 09/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1820 WENTZVILLE PKWY
WENTZVILLE MO
63385-3817
US

IV. Provider business mailing address

1820 WENTZVILLE PKWY
WENTZVILLE MO
63385-3817
US

V. Phone/Fax

Practice location:
  • Phone: 636-887-3317
  • Fax: 636-530-3006
Mailing address:
  • Phone: 636-887-3317
  • Fax: 636-530-3006

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number2022031300
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: