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General NPI Number Information
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NPI Number | 1497872428
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Entity Type | Individual
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Provider Name | LARRY DONNELL PERKINS RPH
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Gender | Male
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Dates
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Enumeration Date | 03/23/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 49 N FLORISSANT RD
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City | FERGUSON
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State | MO
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Zip | 63135-2331
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Country | US
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Telephone | 314-521-1071
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Fax |
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Provider Business Mailing Address
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Address Line | 9407 EASTCHESTER DR
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City | SAINT LOUIS
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State | MO
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Zip | 63136-5115
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Country | US
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Telephone | 314-869-5011
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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 | 043686
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License Number State | MO
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