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General NPI Number Information
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NPI Number | 1578903324
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Entity Type | Individual
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Provider Name | YERVAND SIMONYAN PHARMD
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Gender | Male
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Dates
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Enumeration Date | 06/26/2013
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Last Update Date | 03/09/2022
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Provider Practice Location Address
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Address Line | 1344 AMHERST TERRACE WAY
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City | CHESTERFIELD
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State | MO
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Zip | 63017-6010
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Country | US
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Telephone | 314-898-2835
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Fax |
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Provider Business Mailing Address
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Address Line | 13410 BEAGLE LN
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City | SAINT LOUIS
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State | MO
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Zip | 63141-6007
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Country | US
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Telephone | 314-898-2835
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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 | 2011026625
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License Number State | MO
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