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General NPI Number Information
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NPI Number | 1548094535
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Entity Type | Organization
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Legal Business Name | STRIVE PHARMACY MISSOURI, LLC
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Dates
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Enumeration Date | 08/30/2024
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Last Update Date | 08/30/2024
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Provider Practice Location Address
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Address Line | 2058 FENTON LOGISTICS PARK
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City | FENTON
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State | MO
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Zip | 63026
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Country | US
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Telephone | 877-273-1777
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Fax | 724-213-1905
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Provider Business Mailing Address
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Address Line | 325 N. ASH ST.
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City | GILBERT
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State | AZ
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Zip | 85233
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Country | US
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Telephone | 480-626-4366
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Fax | 480-626-4365
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Authorized Official
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Title or Position | MEMBER
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Name | MICHAEL WALKER
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Credential |
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Telephone | 480-626-4366
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail 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 | 3336M0002X
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Taxonomy Name | Mail Order Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3336S0011X
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Taxonomy Name | Specialty Pharmacy
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License Number |
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License Number State |
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