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General NPI Number Information
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NPI Number | 1063479897
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Entity Type | Organization
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Legal Business Name | RINDERER'S DRUG STORE #2
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Dates
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Enumeration Date | 04/26/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 12141 BELLEFONTAINE RD
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City | SAINT LOUIS
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State | MO
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Zip | 63138-1906
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Country | US
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Telephone | 314-741-8700
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Fax |
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Provider Business Mailing Address
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Address Line | 12141 BELLEFONTAINE RD
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City | SAINT LOUIS
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State | MO
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Zip | 63138-1906
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Country | US
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Telephone | 314-741-8700
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. MATTHEW J CARLISLE
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Credential | R.PH.
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Telephone | 636-928-3957
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PS0023530
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License Number State | MO
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