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General NPI Number Information
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NPI Number | 1407687908
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Entity Type | Individual
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Provider Name | JAMIE JAYCOX
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Gender | Female
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Dates
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Enumeration Date | 08/08/2024
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Last Update Date | 08/08/2024
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Provider Practice Location Address
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Address Line | 7450 HAMPTON AVE
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City | SAINT LOUIS
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State | MO
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Zip | 63109-3931
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Country | US
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Telephone | 314-832-3688
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Fax |
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Provider Business Mailing Address
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Address Line | 9539 FREDRICKSBURG CT
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City | SAPPINGTON
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State | MO
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Zip | 63126-3302
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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 | 2024031947
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License Number State | MO
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