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General NPI Number Information
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NPI Number | 1528669736
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Entity Type | Individual
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Provider Name | REBECCA RIDENHOUR PHARM.D.
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Gender | Female
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Dates
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Enumeration Date | 11/04/2020
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Last Update Date | 11/04/2020
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Provider Practice Location Address
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Address Line | 2 PROGRESS POINT PKWY
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City | O FALLON
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State | MO
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Zip | 63368-2205
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Country | US
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Telephone | 636-344-1200
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Fax |
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Provider Business Mailing Address
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Address Line | 105 BOBCAT CT
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City | WENTZVILLE
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State | MO
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Zip | 63385-3514
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Country | US
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Telephone | 636-295-0478
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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 | 1999139616
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License Number State | MO
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