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General NPI Number Information
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NPI Number | 1164581526
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Entity Type | Organization
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Legal Business Name | SSM HEALTH CARE ST. LOUIS
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Dates
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Enumeration Date | 12/08/2006
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Last Update Date | 10/18/2022
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Provider Practice Location Address
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Address Line | 711 VETERANS MEMORIAL PARKWAY SUITE 102
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City | ST. CHALRES
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State | MO
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Zip | 63303-2106
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Country | US
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Telephone | 636-669-2223
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Fax | 636-669-2222
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Provider Business Mailing Address
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Address Line | 711 VETERANS MEMORIAL PARKWAY SUITE 102
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City | ST. CHARLES
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State | MO
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Zip | 63303
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Country | US
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Telephone | 636-443-2406
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Fax | 636-669-2222
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Authorized Official
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Title or Position | V.P. PHARMACY SERVICES
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Name | KIMBERLY SPENCER
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Credential |
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Telephone | 314-989-2588
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 005663
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License Number State | MO
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