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General NPI Number Information
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NPI Number | 1245509991
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Entity Type | Individual
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Provider Name | FREDERIC J ZUCCHERO R.PH.
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Gender | Male
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Dates
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Enumeration Date | 12/27/2011
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Last Update Date | 12/27/2011
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Provider Practice Location Address
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Address Line | 12647 OLIVE BLVD., SUITE 585 FIRST DATABANK
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City | SAINT LOUIS
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State | MO
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Zip | 63141
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Country | US
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Telephone | 314-878-5125
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Fax |
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Provider Business Mailing Address
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Address Line | 1701 RIDGEMONT CT
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City | SAINT LOUIS
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State | MO
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Zip | 63146-2034
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 029923
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License Number State | MO
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