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General NPI Number Information
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NPI Number | 1689193732
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Entity Type | Organization
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Legal Business Name | CHOICE FLU VACCINATIONS
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Dates
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Enumeration Date | 09/10/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 8016 KNIGHTS CROSSING DR
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City | O FALLON
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State | MO
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Zip | 63368-6208
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Country | US
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Telephone | 314-200-4071
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Fax | 314-200-4059
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Provider Business Mailing Address
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Address Line | 8016 KNIGHTS CROSSING DR
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City | O FALLON
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State | MO
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Zip | 63368-6208
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Country | US
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Telephone | 314-200-4071
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Fax | 314-200-4059
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Authorized Official
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Title or Position | OWNER
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Name | GINA ANN LANIER
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Credential |
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Telephone | 314-200-4071
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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