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General NPI Number Information
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NPI Number | 1710242292
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Entity Type | Organization
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Legal Business Name | DIERBERGS MARKETS INC
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Dates
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Enumeration Date | 07/10/2012
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Last Update Date | 04/04/2014
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Provider Practice Location Address
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Address Line | 1080 LINDEMANN RD
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City | DES PERES
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State | MO
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Zip | 63131-4526
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Country | US
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Telephone | 314-238-0444
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1070
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City | CHESTERFIELD
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State | MO
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Zip | 63006-1070
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Country | US
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Telephone | 636-812-1470
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Fax | 636-812-1603
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Authorized Official
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Title or Position | DIR OF PHCY
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Name | GREG GUENTHER
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Credential |
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Telephone | 636-812-1472
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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 | 2012021344
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License Number State | MO
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