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General NPI Number Information
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NPI Number | 1629695838
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Entity Type | Organization
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Legal Business Name | SSM-SLUH, INC.
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Dates
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Enumeration Date | 07/03/2020
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Last Update Date | 04/14/2023
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Provider Practice Location Address
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Address Line | 1225 S GRAND BLVD
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City | SAINT LOUIS
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State | MO
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Zip | 63104-1016
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Country | US
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Telephone | 314-268-7153
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Fax | 314-268-5166
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Provider Business Mailing Address
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Address Line | 1225 S GRAND BLVD
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City | SAINT LOUIS
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State | MO
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Zip | 63104-1016
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Country | US
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Telephone | 314-268-7153
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Fax | 314-268-5166
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Authorized Official
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Title or Position | V.P. PHARMACY SERVICES
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Name | KIMBERLY SPENCER
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Credential | RPH
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Telephone | 314-989-2588
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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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