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General NPI Number Information
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NPI Number | 1700374808
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Entity Type | Organization
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Legal Business Name | MAH PHARMACY LLC
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Dates
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Enumeration Date | 04/25/2018
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Last Update Date | 09/19/2025
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Provider Practice Location Address
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Address Line | 4600 N HANLEY RD SUITE C
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City | SAINT LOUIS
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State | MO
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Zip | 63134-2715
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Country | US
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Telephone | 314-522-5817
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Fax | 314-522-5818
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Provider Business Mailing Address
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Address Line | 4600 N HANLEY RD SUITE C
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City | SAINT LOUIS
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State | MO
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Zip | 63134-2715
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Country | US
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Telephone | 314-522-5817
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Fax | 314-522-5818
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Authorized Official
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Title or Position | ASSISTANT SECRETARY
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Name | SUSAN PEPPERS
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Credential |
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Telephone | 513-858-4916
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | 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 | 2018008506
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License Number State | MO
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