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General NPI Number Information
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NPI Number | 1154878783
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Entity Type | Organization
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Legal Business Name | LSL-RX, INC
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Dates
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Enumeration Date | 09/01/2016
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Last Update Date | 09/01/2016
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Provider Practice Location Address
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Address Line | 149 POND FORT TRL
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City | LAKE ST LOUIS
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State | MO
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Zip | 63367-4022
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Country | US
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Telephone | 314-440-7565
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Fax |
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Provider Business Mailing Address
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Address Line | 356 LARIMORE VALLEY DR
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City | WILDWOOD
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State | MO
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Zip | 63005-6225
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Country | US
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Telephone | 314-882-3123
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | JENNIFER CARROLL
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Credential | PHARMACIST
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Telephone | 314-440-7565
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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 |
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License Number State |
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