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General NPI Number Information
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NPI Number | 1407880925
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Entity Type | Organization
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Legal Business Name | GLOBAL PHARMALIFE LLC
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Dates
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Enumeration Date | 07/10/2006
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Last Update Date | 02/04/2013
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Provider Practice Location Address
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Address Line | 10479 OLD OLIVE STREET RD
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City | CREVE COEUR
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State | MO
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Zip | 63141-5923
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Country | US
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Telephone | 314-997-7722
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Fax | 404-261-4917
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Provider Business Mailing Address
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Address Line | 10479 OLD OLIVE STREET RD
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City | CREVE COEUR
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State | MO
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Zip | 63141-5923
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Country | US
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Telephone | 314-997-7722
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Fax | 404-261-4917
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Authorized Official
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Title or Position | VP
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Name | MICHAEL BOGACHEK
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Credential |
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Telephone | 404-261-7775
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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 | 2005027475
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License Number State | MO
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